New thinking about antibiotics: Should doctors still advise patients to take the full course?

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A BMJ analysis raises the question of whether doctors should still recommend patients take a full course of antibiotics.

For generations, physicians have been telling patients to make sure they take the full course of antibiotics, but some doctors now question the advice.

In an analysis published in The BMJ, a group of physicians argues that the advice to not stop antibiotics until the prescription is finished is not grounded in scientific evidence. The practice puts patients at risk from antibiotic resistance when treatment is given for longer than necessary, not when the medication is stopped early, the doctors from Brighton and Sussex Medical School, the University of Oxford and other institutions said.

RELATED: WHO takes aim at superbug threat, tells providers to cut back use of some antibiotics

They argue that it’s time for policymakers, educators and doctors to drop the message long given to patients. “Research is needed to determine the most appropriate simple alternative messages, such as stop when you feel better,” they wrote.

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Instead of the general advice to finish a prescription, doctors should tailor treatment direction for individual patients. New clinical trials are needed to determine the best length of antibiotic treatment for specific conditions and situations, the doctors said.

However, some infectious disease experts told The Washington Post that it’s premature to drop the advice being given for decades and argue it’s not such a simple decision of when to stop antibiotics. Lauri Hicks, director of an office that focuses on antibiotics for the Centers for Disease Control and Prevention, told the newspaper there are some studies that establish the ideal duration of antibiotics for specific illnesses. For instance, 10 days on antibiotics for an ear infection is more effective than five days of medication. Hicks also said there is evidence that failure to complete a course of antibiotics makes it more likely bacteria on a person’s body may develop antibiotic resistance that can cause a more serious infection in the future.

Global health experts have increasingly warned that superbugs are poised to be a significant threat to patient health. Providers can do their part by focusing on antibiotic stewardship. National healthcare organizations, including the Centers for Medicare & Medicaid Services, have offered guidelines.