Are Doctors Wrong About Finishing Your Antibiotics?

Scientists have long offered several solutions to the rise of antibiotic-resistant bacterial infections, but this one will surprise you: Don’t finish your treatment course.

The antibiotic era began in the mid-1930s with the development of sulfa drugs and leaped forward in the early 1940s with the mass production of penicillin. Since then, scientists have developed a wide variety of types of antibiotics. Nonetheless, with their overuse, many strains of bacteria have become resistant. Methicillin-resistant Staphylococcus aureus (MRSA) and extended spectrum ß-lactamase producing and carbapenem-resistant opportunistic bacteria have become increasingly problematic. Occasionally, patients get infected with bacteria resistant to all commercially available antibiotics. In other words, we’ve taken our first steps into the post-antibiotic era.

The best way to reduce the problem of resistant bacteria is to refrain from giving antibiotics to patients who don’t need them. Many prescriptions are written for symptoms such as cough, runny nose, and congestion—infections that are often caused by viruses for which antibiotics are useless. The all-to-easy-to-remember Z-pack (azithromycin) is a prime offender.

Viruses can also cause pneumonia and sore throats. Because bacteria can also cause these diseases, doctors should make every effort to determine whether these infections are actually caused by bacteria before writing a prescription. For example, rapid diagnostic tests can distinguish viral throat infections from strep throats and chest X-rays can distinguish viral pneumonias from bacterial pneumonias.

Another important factor in preventing antibiotic resistance is vaccination, especially with the pneumococcal and influenza vaccines. Although influenza is a virus, influenza pneumonia can make the body predisposed to bacterial pneumonias caused by pneumococcus and staph. It’s much easier to avoid antibiotics if patients aren’t infected in the first place.

One factor working against doctors in reducing the problem of antibiotic resistance is history. For decades, doctors and patients have believed that finishing the prescribed course of antibiotics can help prevent the development of antibiotic resistance, even though little evidence is available to support this claim. On the other hand, abundant evidence supports the fact that prolonged use of antibiotics promotes bacterial resistance.

The dictum that it is important to finish the antibiotic course is…

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