Patients should stop taking antibiotics when they feel better, experts say


"In many previously healthy patients with acute infections, letting them stop the antibiotics once they feel better has considerable appeal". Instead, they say there is evidence that stopping antibiotics sooner is a safe and effective way to reduce overuse of the drugs.

Writing in the British Medical Journal, they argue the "complete the course" message isn't supported by the evidence.

So in other words, shortening a course of antibiotics to the bare minimum to fight the illness might be the best way to minimise the risk of resistance.

"This is slow-motion fake news".

In fact, patients are put at unnecessary risk from antibiotic resistance when treatment is given for longer than necessary - not when it is stopped early, according to Professor Martin Llewelyn at Brighton and Sussex Medical School and colleagues.

It may be attributable to unproven speculation by Alexander Fleming, the biologist who discovered penicillin, they said.

An entire course of antibiotics doesn't always mean consuming an entire packet and patients should double check with their doctor the length of treatment required, advised Dr Bartone.

Dr. Sharon Meropol, a pediatrician and epidemiologist at Case Western Reserve University School of Medicine, says she's "glad someone finally wrote this paper", and that she "mostly agrees" with the authors' recommendations.

It has now been shown that the bacteria Fleming named in his tale, Streptococcus pyogenes, never actually developed resistance to penicillin, casting his hypothesis further into doubt.

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Antimicrobial resistance is caused when bacteria, viruses, fungi and parasites change through continued exposure to drugs, which then become ineffective against them.

England's chief medical officer Dame Sally Davies has warned that 50,000 people die each year in Europe and the United States from infections that have developed resistance against antibiotics. Rather, it is a populationwide phenomenon in which bacteria spread from host to host, acquire all kinds of genetic traits, and may be resistant to a particular antibiotic before the bacteria even enter your body.

"Antibiotics are a precious and finite natural resource which should be conserved by tailoring treatment duration for individual patients", she added.

Professor Helen Stokes-Lampard, chairman of the Royal College of Global Positioning System, said patients should not change their behaviour "based on one study".

"In many cases courses are quite short, for example for urinary tract infections, three days is often enough to cure the infection", she said.

This group of "specialists", from prominent organisations that include Public Health England and the University of Oxford, have suggested that patients should only continue taking medication until they feel better, to avoid the overuse of drugs. Eventually those robust microbes can outsmart available drugs, and even pass on survival instructions to other bacterial strains.That's why most doctors-along with the World Health Organization and the U.S. Centers for Disease Control and Prevention-urge patients to always complete prescribed drug courses, even after they feel better. "But we're not at that stage yet".

Alison Holmes, director of Infection Prevention and Control at Imperial College Healthcare NHS Trust, said the "dogma" of telling patients to complete the course of antibiotics "has been pervasive and persistent".

But, he says, says clinical trials to prove a need for much shorter antibiotic courses.