Is it Really Necessary to Finish a Course of Antibiotics When you’ve Already Recovered?

The simple answer is no. For many years we were told that in order to achieve a speedy recovery with less chance of the ailment coming back, we must finish the course of prescribed antibiotics. However, scientists are now beginning to realise that this is a double edged sword and now we have an emerging issue of antibiotic resistance to deal with.

Antibiotic resistance is a real threat to society as treating patients becomes extremely difficult for doctors. And while conventional wisdom led us to believe that finishing a course of antibiotics prescribed by the doctor was the right thing to do, experts are now starting to backtrack on that idea altogether.

With the exception of a very few extreme cases, most people with infections today only require a short course of antibiotics. “The number of antibiotics patients are prescribed nowadays has more to do with the number of days in the week than it does any scientific evidence”, suggested one infectious disease doctor.

In a recent BMJ study, researchers reviewed the data on a number of common infections to get an idea as to the average time it took patients to recover. The results showed that with most conditions, patients who received shorter courses of treatment still achieved the same cure rate as those who received longer lasting prescriptions. However, there was one exception to that rule - children with middle ear infections. For some reason these children did receive higher cure rates after taking 10 days worth of antibiotics as opposed to five.

During the study, researchers also looked at the patient's probability of having antibiotic-resistant bacteria in the body after receiving antibiotic treatment. The results confirmed what the researchers had suspected - that patients who received longer antibiotic treatments were more susceptible to antibiotic-resistant bacteria.

To try and combat the problem of issuing more antibiotics than necessary, new clinical tools are being developed that will assist doctors find the right limit. One such tool is a blood test called procalcitonin. Procalcitonin levels increase when patients are suffering from serious bacterial infections. Those suffering from viral infections have reduced levels of procalcitonin. Medical professionals currently use procalcitonin levels in hospitals to help determine whether antibiotics are needed for patients suffering with pneumonia or COPD (chronic obstructive pulmonary disease).

Although antibiotics may not be necessary for all infections, there are still a few that do require long-term antibiotic treatments. This is particularly true in those suffering from infections that have led to hospitalisation, including bone or bloodstream infections. But, there are a few things to keep in mind when it comes to antibiotics:

  • There's no proof that taking a longer course of antibiotics will prevent antibiotic resistance. It could be that the longer course of treatment causes an antibiotic resistance.
  • Consult your doctor if your symptoms are no longer present and you feel you don't need to finish your prescribed course. An infection could still be lingering even though there's no physical sign.
  • We don't have an unlimited supply of antibiotics and they should be used only when absolutely necessary.
  • Not all infections require the use of antibiotics to treat them.
  • Antibiotics may cause serious side effects, including clostridium difficile colitis.
  • Recovery times differ depending on the patient and so some may need a longer course of antibiotics than others to treat the same infection.
  • Always follow your doctor's advice when it comes to the length of your antibiotic therapy treatment.

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