With the spectre of drug-resistant diseases like gonorrhoea looming over the worlds’ consciousness, traditional advice is that people make every effort to ensure that they complete antibiotic courses prescribed by their doctor. However, a new study entitled The Antibiotic Course has had its Day turns that advice on its head.
The study, which was published in the British Medical Journal, claims there is no evidence to prove that completing the entire course of antibiotics will prevent the emergence of resistant microbes. In fact, “when a patient takes antibiotics for any reason, antibiotic sensitive species and strains present in commensal flora on their skin, or gut, or in the environment are replaced by resistant species and strains ready to cause infection in the future,” it reads.
In 2016, the World Health Organisation (WHO) released an urgent statement about the seriousness of the threat of antibiotic resistance. The WHO called it “one of the biggest threats to global health, food security, and development today,” further noting that “a growing number of infections – such as pneumonia, tuberculosis, and gonorrhoea – are becoming harder to treat, as the antibiotics used to treat them become less effective”.
The researchers argue that instead of preventing resistance, the current antibiotic prescription standards may actually hinder attempts to stop unnecessary usage, which could decrease resistance.
“The fallacious belief that antibiotic courses should always be completed to minimise resistance is likely to be an important barrier to reducing unnecessary antibiotic use in clinical practice and to developing evidence to guide optimal antibiotic use,” the researchers found.
If anything, prescribing short courses of antibiotics may work better for the patient and decreasing resistance: “Not only does an individual patient’s risk of resistant infection depend on their previous antibiotic exposure, but reducing that exposure by shorter treatment is associated with reduced risk of resistant infection and better clinical outcome,” the researchers found.
Instead of telling people that completing their antibiotics will prevent resistance, the study suggests that a different message needs to be devised in order to change, which includes telling patients to stop when they feel better.
“Until then, public education about antibiotics should highlight the fact that antibiotic resistance is primarily the result of antibiotic overuse and is not prevented by completing a course,” the study says.
Source: The British Medical Journal
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