Mar 25 2018

Age old theory of finishing antibiotics is questioned in new report

Published by at 12:38 pm under Antibiotics

Age old theory of finishing antibiotics is questioned in new reports.
In a quest to mitigate antibiotic resistant superbugs, researchers explore a road less traveled.

As long as I can remember, when prescribed antibiotics, the directions have been to finish the prescription, even though your symptoms of illness have passed.  With the worldwide concern of antibiotic resistant superbugs looming in the minds of health professional everywhere, a group of experts are thinking outside the box. Martin Llewelyn, a professor of infection diseases at Brighton and Sussex medical school and his colleagues,  are questioning this theory, and are now telling patients that once they are feeling better, stopping antibiotic treatment may be wiser than finishing the course. (1,2)* ,

The school of thought that has been deeply planted in the minds of doctors and the public for years has been that if we don’t complete our entire prescription of antibiotics when prescribed, we won’t completely kill the offending bacteria, and as a result, it will come back stronger and more resilient…thus leading to the creation of superbugs that are antibiotic resistant. (1,2)*

In an analysis in the British Medical Journal, Llewelyn and his colleagues say,  “…the idea that stopping antibiotic treatment early encourages antibiotic resistance is not supported by evidence, while taking antibiotics for longer than necessary increases the risk of resistance…” (1,2)*

They acknowledge that there are those diseases in which resistance will develop if the antibiotics are not taken long enough, as in the case of tuberculosis. But, the bacteria that usually cause illness are found everywhere and on everybody, such as E coli and Staphylococcus aureus, and we get ill only when those bugs get into the bloodstream or our guts. In these cases, they state that “…the longer such bacteria are exposed to antibiotics, the more likely it is that resistance will develop…” (1,2)*

According to these experts, there has not been sufficient research into the “ideal length of a course of antibiotics, which also varies from one individual to the next, depending in part on what antibiotics they have taken in the past…” (1,2)*

They feel that outside of the hospital setting where patients can’t be tested regularly to know when antibiotic treatment is ok to stop, the health marker would be simply when the patient feels better. Note that this contradicts the platform of the World Health Organization. (1,2)*

Other infectious disease experts chimed in to support this theory, including Peter Openshaw, president of the British Society for Immunology. “…“I have always thought it to be illogical to say that stopping antibiotic treatment early promotes the emergence of drug-resistant organisms…”(1,2)*

 Another, Alison Holmes, who is an infectious disease professor at Imperial College London, said  that Professor Harold Lamber, a great British authority, made this same conclusion back in 1999 in an article entitled “Don’t keep taking the tablets”. “…“It remains astonishing that apart from some specific infections and conditions, we still do not know more about the optimum duration of courses or indeed doses in many conditions, yet this dogma has been pervasive and persistent.”…” (1,2)*

Holmes adds that “This brief but authoritative review supports the idea that antibiotics may be used more sparingly, pointing out that the evidence for a long duration of therapy is, at best, tenuous. Far from being irresponsible, shortening the duration of a course of antibiotics might make antibiotic resistance less likely.” (1,2)*

Jodi Lindsay, a professor of microbial pathogenesis at St George’s, University of London, called it “sensible advice,” and said “…“The evidence for ‘completing the course’ is poor, and the length of the course of antibiotics has been estimated based on a fear of under-treating rather than any studies. The evidence for shorter courses of antibiotics being equal to longer courses, in terms of cure or outcome, is generally good, although more studies would help and there are a few exceptions when longer courses are better – for example, TB.”…” (1,2)*

Of course there is a concern that the way we have been taught in the past is the right way. Professor Helen Stokes-Lampard, Chair of the Royal College of GPs shared her concerns. “…“Recommended courses of antibiotics are not random. They are tailored to individual conditions and in many cases, courses are quite short – for urinary tract infections, for example, three days is often enough to cure the infection.”…” ,And in literature in support of Antibiotic Awareness Week 2016, the World Health Organization  “…advised patients to “always complete the full prescription, even if you feel better, because stopping treatment early promotes the growth of drug-resistant bacteria..” (1,2)*

There is concern that this new information will just confuse people. There is the possibility that even though people feel better, their infection is not completely gone and could return. But it does seem that cases can be looked at individually. In fact, in contradiction to previous advice, “…current public information materials from the US Centers for Disease Control and Prevention (CDC) and Public Health England have replaced “complete the course” with messages advocating taking antibiotics “exactly as prescribed.”…”

The consensus seems to be that more research is needed to fully advise the public on this new unveiling. As for now, if you are prescribed antibiotics for a bacterial infection, follow the advice of a trusted health care professional as to how long you should take them. (1,2)*

Regardless of the duration, antibiotics do wipe out your good bacteria along with the bad. A shorter duration may not make much of a difference, but perhaps some. Once you complete antibiotics treatment, always increase your intake of Body Biotics™ SBO Bio-Identical Probiotics Consortia™ to help replenish the good bacteria you lost. Antibiotics can cause diarrhea and stomach upset, as well, and probiotics help minimize this.*

Healthiest wishes,

Kelli

www.bodybiotics.com

 

Resources:

          1.   https://www.theguardian.com/society/2017/jul/26/rule-patients-must-finish-antibiotics-course-wrong-study-says

  2.   http://www.bmj.com/content/358/bmj.j3418

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