Should you always finish a course of antibiotics? The question was put to almost 1,500 Americans, the majority of whom agreed in the affirmative — despite recent scientific evidence suggesting this may not always be the case, according to researchers.
The survey findings were published in the journal Open Forum Infectious Diseases.
“We were struck that nearly nine in ten respondents believed it was important to always finish an antibiotic course,” first author Alistair Thorpe, a research assistant professor of population health sciences at the University of Utah, told Discover.
“There is no single duration that is right for every infection,” said Thorpe. “The broad clinical direction is to use the shortest course that is effective for the specific infection and patient.”
He explained that the appropriate duration can vary depending on the diagnosis, the severity of the illness, the antibiotic being used, the response to treatment, and the patient’s individual risk factors. Adding, “Patients should take antibiotics exactly as prescribed and speak with their clinician before stopping or changing their treatment.”
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What the Survey Said About Antibiotic Use
Thorpe and colleagues asked participants a number of questions about antibiotic use, including whether they would prefer a longer (7 or more days) or shorter (3 to 5 days) course of antibiotics for a bacterial respiratory infection, such as pneumonia.
The majority (approximately 60 percent) responded with the former, stating they would be more comfortable receiving a longer course. This remained the case amongst almost all demographic groups, with those in the 18- to 33-year-old age bracket being a notable exception, showing a slight preference for a shorter course.
Given reasons tended towards the belief that longer courses are safer and more effective, with respondents stating “It’s better to be Safe than Sorry [sic]” and “I would be more comfortable with a longer antibiotic to be sure infection is going away and would not reoccur.”
In contrast, those who preferred shorter courses cited reasons including adverse side effects and antibiotic resistance. They also displayed a greater aversion to medicine in general.
When asked whether they agree with the statement “Even if you start to feel better, it is important to always finish a prescribed course of antibiotics,” almost nine in ten (88 percent) said yes, with three quarters saying they received this advice from a medical professional.
Preventing Antibiotic Resistance
For decades, the consensus has been that patients should complete a course of antibiotics. The inventor of Penicillin, Alexander Fleming, was already cautioning against antibiotic resistance in the 1940s, warning that using too little of the drug could enable bacteria to evolve resistance.
Thorpe said this was an important warning about adequate dosage, but it was not necessarily evidence that all patients should always complete a full course. Indeed, others have argued that taking antibiotics for longer than necessary could encourage antibiotic resistance, according to the BMJ.
“We now have a much larger body of evidence showing that, for many common infections, appropriately selected shorter courses work just as well and can reduce unnecessary antibiotic exposure and side effects,” said Thorpe. “There are important exceptions, including tuberculosis, so the right duration still depends on the infection and the individual patient.”
More Nuanced Messaging Around Antibiotics
Thorpe and colleagues advocate for more nuanced messaging.
“I see this as a real opportunity to show people how medical science is supposed to work: recommendations change as we do better studies and better evidence becomes available,” said Thorpe. “We should communicate that change transparently, explain why it has happened, and ideally avoid replacing one oversimplified slogan with another.”
When it comes to taking antibiotics, the Centers for Disease Control and Prevention (CDC) advises patients to take treatment exactly as prescribed and to talk to a healthcare professional if they have any questions.
This article is not offering medical advice and should be used for informational purposes only.
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Article Sources
Our writers at Discovermagazine.com use peer-reviewed studies and high-quality sources for our articles, and our editors review for scientific accuracy and editorial standards. Review the sources used below for this article:
- This article references information from the BMJ: The antibiotic course has had its day
- This article references information from the CDC: Healthy Habits: Antibiotic Do's and Don'ts
- This article references information from a study published in the Open Forum Infectious Diseases: US Adults’ Perspectives on Antibiotic Durations and Adherence to Therapy for Common Bacterial Respiratory Infections: A National Survey