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

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The rule that patients must finish their course of antibiotics is wrong, according to experts.

Doctors have historically told patients that they must complete their course of antibiotics to lower the risk of developing a resistance to the drug.

But researchers are now saying that the “complete the course” warning is not supported by any evidence.

In an observational study published in the British Medical Journal (BMJ), experts say taking antibiotics for longer than necessary will increase the risk of resistance as opposed to stopping it early. 

Martin Llewelyn, a professor at Brighton and Sussex medical school, and colleagues, say the longer bacterium is exposed to antibiotics, the more likely it is that resistance will develop.

The authors of the study said: “Currently, we largely ignore this fact and instead make indication specific recommendations for antibiotic duration that are based on poor evidence.

“Outside hospital, where repeated testing may not be feasible, patients might be best advised to stop treatment when they feel better, in direct contradiction of WHO (World Health Organisation) advice.”

There are some diseases, such as tuberculosis, where the bug can become resistant if the drugs are not taken for long enough.

But for common bacterial infections no evidence exists that stopping antibiotic treatment early increases a patient’s risk of resistant infection, the experts said.

A spokesman for the Royal Pharmaceutical Society and consultant pharmacist Dr Kieran Hand, said: “As researchers have pointed out, further research is needed before the ‘finish the course’ mantra for antibiotics is changed and any alternative message such as ‘stop when you feel better’ can be confidently advocated.

“Patients should be encouraged to return unused antibiotics to a pharmacy for safe disposal rather than putting them in the bin, or even worse, saving them for future use or sharing them with friends and family as this could really contribute towards antibiotic resistance.”

The Department of Health and NICE (the National Institute for Health and Care Excellence) are both set to review the evidence on prescribing the drug and develop guidance for managing common infections. 


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