Finishing Your Course of Antibiotics May No Longer Be the Standard for Some Infections

Should you always complete the full course of antibiotics prescribed by your doctor? Recent research suggests that may not always be the best course of action. A recent survey of nearly 1,500 Americans showed that the majority (around 90 percent) agreed that finishing a prescription was important, despite scientific evidence indicating otherwise.

According to Alistair Thorpe, the study's lead author from the University of Utah, there is no one-size-fits-all duration for antibiotic treatment. The length of a course depends on the infection, the severity of symptoms, the type of antibiotic used, the patient's response, and their individual risk factors. Thorpe emphasized that the right duration is determined by the specific situation and patient. He stressed that patients should follow their clinician's instructions and not stop or alter treatment on their own.

The survey presented participants with questions about their preferences for longer (seven or more days) versus shorter (three to five days) courses of antibiotics for a common bacterial respiratory infection like pneumonia. Approximately 60 percent of respondents favored the longer duration. This preference was even more pronounced among younger adults aged 18 to 33, who showed a slight inclination towards shorter courses.

People often gave reasons like safety and effectiveness for wanting longer courses. Some stated, "It's better to be safe than sorry" and "I would feel more comfortable with a longer antibiotic to ensure the infection is fully cleared and won't come back." On the other hand, those who preferred shorter courses cited concerns about side effects and the potential for antibiotic resistance. These individuals also generally had a lower tolerance for medication in general.

When asked about the advice "Even if you start to feel better, it's crucial to finish the prescribed course of antibiotics," nearly 88 percent of respondents agreed. Most said they received this recommendation from a healthcare professional.

Studies have long advised patients to complete antibiotic courses to prevent antibiotic resistance, a concern that dates back to the 1940s when Alexander Fleming, the Penicillin inventor, warned about the dangers of using too little of the drug. While Thorpe acknowledged this advice is valid, he pointed out that the current evidence suggests shorter, appropriately selected courses can be just as effective for many common infections.

Thorpe and his colleagues advocate for more nuanced messaging around antibiotic use. They argue that medical recommendations should evolve as new evidence emerges, instead of relying on simple slogans that may lead to misunderstanding. They suggest communicating these changes transparently, explaining the reasons behind them, and avoiding replacing one oversimplified message with another.

The Centers for Disease Control and Prevention (CDC) advises patients to follow their doctor's prescription exactly and to consult with a healthcare professional if they have any questions. This article provides general information and should not be considered medical advice.