Advice that patients should complete a course of antibiotics is not supported by evidence and should be dropped, according to researchers at Brighton and Sussex Medical School (BSMS) and colleagues.
The authors of the paper in the BMJ call for a change of message regarding antibiotic use, arguing that patients are actually being put at unnecessary risk from antibiotic resistance when treatment is given for longer than necessary, rather than when it is stopped early, as commonly believed.
Lead author Martin J Llewelyn, Professor of Infectious Diseases at BSMS, said: "While the 'complete the course' message is one we all know, we have found that it is time for this message to change. The belief that stopping antibiotic treatment increases the risk of antibiotic resistance is not supported by evidence. In fact, this risk is actually increased by taking antibiotics for longer than is necessary."
The researchers ask for policy makers, educators, and doctors to drop this message and state that this was not evidence-based and is incorrect. Prof Llewelyn added: "Although the 'complete the course' message is clear and simple to follow, it is time that we promote a more effective way of reducing antibiotic overuse. Further research is needed to find a new message that works for the public, such as 'Stop when you feel better'.
Antibiotics are key to healthcare, and the growing global threat of antibiotic resistance challenges the success of many treatments. Antibiotic resistance is primarily the result of antibiotic overuse, and is important that treatment is tailored to the individual patient.
The analysis was done for the ARK-hospital PGfAR programme and for the National Institute of Health Research's Health Protection Unit at Oxford University.
Article: The antibiotic course has had its day, Martin J Llewelyn et al., BMJ, doi: 10.1136/bmj.j3418, published 26 July 2017.