Should you finish a course of antibiotics?
Published 2 Aug 2017
Instead, they suggest, more studies need to be done to see if stopping once feeling better can help cut antibiotic use. But GPs urge people not to change their behaviour in the face of one study.
Prof Helen Stokes-Lampard, leader of the Royal College of General Practitioners, said an improvement in symptoms did not necessarily mean the infection had been completely eradicated. "It's important that patients have clear messages, and the mantra to always take the full course of antibiotics is well known - changing this will simply confuse people."
'Short and tailored'
The opinion piece, by a team of researchers from across England, argues that reducing the use of antibiotics is essential to help combat the growing problem of antibiotic resistance.
Prof Martin Llewelyn, from the Brighton and Sussex Medical School, together with colleagues, argues that using antibiotics for longer than necessary can increase the risk of resistance. He suggests traditional long prescriptions for antibiotics were based on the outdated idea that resistance to an antibiotic could develop when a drug was not taken for a lengthy time and an infection was undertreated.
Instead, he says, there is now growing evidence that short courses of antibiotics - lasting three to five days, for example - work just as well to treat many bugs. He accepts there are a few exceptions - for example, giving just one type of antibiotic for TB infections - which is known to lead to rapid resistance.
But the team says it is important to move away from blanket prescriptions and, with more research, give antibiotic prescriptions that are tailored to each infection and each person.
The study acknowledges that hospitals are increasingly reviewing the need for antibiotics from day to day and that there is a growing trend towards shorter courses of drugs. But it questions whether advice such as stopping once feeling better would be beneficial - particularly when patients do not get the opportunity to be reviewed in the hospital every day.
They accept this idea would need more research.
Prof Helen Stokes-Lampard, leader of the Royal College of General Practitioners, says while it is important to take new evidence into account, she "cannot advocate widespread behaviour change on the results of just one study". She says recommended courses of antibiotics are "not random" but tailored to individual conditions and in many cases courses are quite short.
And she says: "We are concerned about the concept of patients stopping taking their medication mid-way through a course once they 'feel better', because improvement in symptoms does not necessarily mean the infection has been completely eradicated."
Meanwhile, Kieran Hand, spokesman for the Royal Pharmaceutical Society, said: "This opinion article from respected NHS infection experts is a welcome opening of the debate in the UK on the relationship between the length of a course of antibiotics, efficacy and resistance.
"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.
"The ideal future scenario would be that the right length of treatment for a specific infection for patients is identified from clinical trials and the exact quantity prescribed and dispensed."
Public Health England says patients should continue to follow their health professional's advice about using antibiotics.
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hello im new to this site. But yes if ur doctor recommends abx, then complete the course. My issue is that in general practice antibiotics are given too freely. Thing is stay at home and nurse the illness. Antibiotics are only needed when a person is really septic. So the problem is people need to stop demanding drugs, a little knowedge is dangerous.
Yes you should finish the course of Antibiotics, as the doctor said on TV, till its made more clear, been doing it for years why stop now!
I always finish my Doxycycline, when I'm having a flare up from my C.O.P.D.,,,
Absolutely. You should always finish the course of antibiotics. Many people make the mistake of stopping them half way through the course because they feel better, not realizing that the condition is not cured but suppressed a little for having started the course. It only returns and then you have to start another course all over again. So how ever well you feel after starting the course, you must always finish the entire course.
Hi, first time talking on here as i don't have a lot of strength, and i am in constant pain. I have been advised to have all my teeth out as have severe autoimmune deficiency Sjogren's, Hashimoto's, lupus, brittle bones, crushed vertebrae, kyphosis, asthma, and breast and lymph node cancer, i cannot have chemo as it would kill me right off, the problem is that i have a huge infection caused by pockets in my well looked after teeth (periodontitis) for 2 months it has caused me so much pain swelling glands, a cough could be cardiac, or the bacteria, no one knows, have had 3 lots of antibiotics, as soon as i stop using them it all comes back. the pressure on my teeth is nasty and having permanent toothache feel sick and my body feels poisoned. sleep in shifts and get about 16 hours sleep as exhausted. I live alone have no help, and i would be a lot better without the teeth. dilemma do i keep taking the antibiotics, or as has been suggested have all my teeth out and risk sepsis.. I don't know what decision to make.. And how much antibiotics can a body take before the body becomes used to it?
@blesley29
I am truly sorry to hear what you are going through. The only people who can best advise you are your Dentist and your GP. I am sure that who ever prescribed you the antibiotics will have done a blood test to check culture and sensitivity, because if you are given the antibiotics that you are resistant to, they will not work. Have you always completed your course, or have you given them up part way through. It is true that if you are constantly on antibiotics, your system gets used to it and it does not have much effect on your illness. If having all your teeth out is the best option for you, then I would go for it and stop the misery. When your mouth is properly cured, you can always go for Dentures. There is no shame in wearing dentures. Comfort comes before vanity. Please don't just rely on my advice. Do talk to your GP and the Dentist.
Wish you Good Luck. You have enough on your plate as it is.
C. Chetwynd.
