Doctors and patients all over the world have long followed the same wisdom when taking antibiotics: it's important to finish the entire course prescribed. Stopping midway through a course of prescribed antibiotics is said to give bacteria breathing space, which can allow it to mutate and develop immunity to the drug. Researchers from the Brighton and Sussex Medical School (BSMS) are challenging the age-old wisdom with the results of a study that showed this may not necessarily always be the case.
The team, led by Martin Llewelyn, published their findings in the British Medical Journal, asserting there's no evidence to support the long-held notion. “While the ‘complete the course’ message is one we all know, we have found that it is time for this message to change," Llewelyn said in a BSMS press release. "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 did, however, acknowledged that there are diseases (like tuberculosis) where bacteria can develop antibiotic resistance when not exposed to drugs for a long enough period. However, the most common bugs like E.coli and Staphylococcus aureus, are more likely to become superbugs the longer they are exposed to antibiotics.
A Serious Concern
Antibiotic or antimicrobial resistance is a growing concern that is becoming increasingly more widely acknowledged within the medical community. In fact, the United Nations has already elevated the issue to the level of a health crisis. In the United States alone, about 2 million people become infected with antibiotic resistant bacteria each year. Some 23,000 of those patients die as a result.
A number of studies have been launched in attempts to find a solution to this crisis. One team has turned to gene-editing, using CRISPR to delete antibiotic resistant strains of bacteria. Another recent study suggested tracking which genes could potentially turn pathogens into superbugs; data which the ream hoped could be used to help develop a new types of antibiotics.
Meanwhile, the new BSMS research suggests a change in mentality may be what's required — and several other experts agree. Still, further research is required before any official prescribing guidelines could be updated.
Of course, not everyone in the medical community agrees that they should be: chair of the Royal College of GP's Helen Stokes-Lampard urged caution, however. “We are concerned about the concept of patients stopping taking their medication midway through a course once they ‘feel better’, because improvement in symptoms does not necessarily mean the infection has been completely eradicated. It’s important that patients have clear messages and the mantra to always take the full course of antibiotics is well known," she told The Guardian. "Changing this will simply confuse people.”