When is the right time to stop taking antibiotics?

Press coverage has picked up on an interesting paper The antibiotic course has had its day published in the British Medical Journal (online 26th July 2017). The paper was of interest to me as I studied antibiotic resistance for my PhD, and this topic was also the theme of (to date) my only appearance on TV news.

bmjab

As anyone who has ever been prescribed antibiotics ought to know, current clinical practice from the World Health Organisation and others recommends completion of the course (often 7 days), even if the patient feels better sooner. The justification for this strategy has been concern that premature ending of treatment might allow the disease-causing bacteria to recover and continue to wreak havoc, possibly in a newly-resistant manner.

In the new paper, Martin Llewelyn (Brighton and Sussex Medical School) and colleagues from a number of institutions in South-East England question the basis of this recommendation. Whereas the link between exposure to antibacterials and the development of resistance is well documented, these authors wondered about the origins of the original advice. They suggest that the requirement to “complete the course” probably stands on little more than the anecdotal experience of some of the antibiotic pioneers. Continue reading

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