Finish your antibiotics course? Maybe not, say BMJ - News & Features

27 July 2017
Finish your antibiotics course? Maybe not, say BMJ

It’s time to rethink the accepted advice that people should always complete an entire course of antibiotics, experts in the BMJ say. Martin Llewelyn, of Brighton and Sussex Medical School, and nine colleagues from universities across the country have urged health officials and school biology teachers to “stop advocating ‘complete the course’ ” and “publicly and actively state that this was not evidence-based and is incorrect”.

It’s a stance that challenges a variety of orthodoxies and while valid, could potentially create public confusion. Prof Mark Fielder, President of the Society for Applied Microbiology welcomed the debate, but advised caution.

“The recent publication in the BMJ, of an article questioning the importance of completing an antibiotic course as prescribed, raises some important questions. Whilst it is healthy to debate current procedures in science and medicine, it is also important to ensure continuation of best practice, unless new evidence suggests otherwise.

“This opinion piece suggests the prescribing policy around antibiotics requires further evidence in relation to completing the full prescribed course. Discussions regarding maintenance and improvement of antibiotic therapy and use are always welcome. However, it is also important to understand that use of the current guidelines should be maintained in the absence of any research-based information to the contrary.

“In line with the comments made by Public Health England, it’s imperative for patients to follow instructions given by their prescribing physician or pharmacist. It’s essential that the full course of antibiotics are used to ensure the drug has the opportunity to act against the invading organism and achieve the best outcome for the patient.

“This approach will also help in the prevention of resistance development. If the correct antibiotic is prescribed and administered in the most appropriate way, this offers the best opportunity for the organism to be killed. Dead organisms do not mutate and cannot develop resistance.”

Public Health England says patients should continue to follow their health professional's advice about using antibiotics.