Should you always finish your full course of antibiotics?

A recent report claims you might not need to

We’re always being told how important it is to finish a course of antibiotics to prevent resistance developing, but a new report has suggested this isn’t necessary, and could in fact be more dangerous. So what are the facts, and what do we recommend here at A.Vogel?

Where has this new information come from?

If you’ve ever been prescribed antibiotics for an infection, you’ll likely remember how much importance is placed on finishing the course of medication regardless of how quickly you feel better. However, a recent report published in the British Medical Journal has suggested that this advice is wrong.

The authors of the report argue that ‘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

They claim that this fear of stopping an antibiotic course too early stems from assumptions made back in the 1940s. They argue that since then, not enough research has been conducted into the relationship between resistance and short antibiotic courses and that ‘for most indications, studies to identify the minimum effective treatment duration simply have not been performed’.

What does the report recommend instead?

Many recent articles have hooked onto the report’s recommendation that patients stop taking antibiotics when they feel better. However, the report is not quite as simple as that.

They do suggest ‘patients might be best advised to stop treatment when they feel better, in direct contradiction of WHO advice’. However, the use of the word ‘might’ here is important – this suggestion is merely given as an idea of what message could be given to patients rather than completing the course.

In fact, they also argue that more research is needed to determine what this alternative message could be, and that more research is needed to determine the minimum length of prescription needed for the most common antibiotics.

My advice

Antibiotic resistance is certainly becoming a worrying problem these days, with cases of incurable gonorrhoea becoming more and more common and an estimated 700,000 people dying from antibiotic-resistant infections in the UK every year. If the current situation does not improve, this could lead to as many as 10 million deaths per year by 2050, according to a recent UN report. It is therefore important that more research like this is conducted to avoid resistance from developing.
The report certainly makes lots of interesting and likely valid points, and it will be interesting to see what further research is conducted into this concept in the future. From a clinical point of view, it is clear that some people recover faster than others and using antibiotics for longer (or more) than is necessary is one of the causes of antibiotic resistance – so there is some logic in this suggestion.
It may be that future generations will not be advised to always finish the full course of antibiotics as we have.
However, until more research is conducted into this concept, I would recommend following your GP's instructions when it comes to taking antibiotics, and in most cases, this will be to complete the course.

What can you do instead to reduce antibiotic use?

If you’re worried about antibiotic use and resistance, then limiting the need for antibiotics might be a better idea than adjusting your dose when you do need them.

Firstly, don’t ask your GP for antibiotics if you don’t really need them. For colds and flu, for example, antibiotics will not help as these are viral infections. While UTIs, on the other hand, are caused by bacterial infections, it is worth treating mild cases at home before seeing a GP. Of course, for serious infections of any kind it is important to see your GP and follow their treatment advice.

I’d really recommend opting for herbal and natural treatments wherever you can. Echinaforce is a fantastic remedy for colds, flu and other upper respiratory infections. It is available as tablets, in liquid form, or as a hot drink and contains whole, fresh Echinacea. Since Echinacea plants contain hundreds of active compounds, the chances of bacteria becoming resistant are very low.

For more information about treating specific illnesses naturally follow these links:

Finally, and this might seem like a strange one, but swap to organic meat rather than non-organic meat. This doesn’t have anything to do with you taking antibiotics directly, but it will contribute to a reduction in antibiotic use generally. This is because for meat to be classed as organic, it needs to adhere to stricter regulations when it comes to antibiotic use, which is great news because at the moment animal agriculture is responsible for around 40% of all antibiotics used in the UK. The more people that switch to organic meat, the less antibiotics will be wasted.

Prevention is better than cure!

Making sure your immune system is in tip-top condition is a good way to avoid infections or make it easier to fight them off when they do occur, further reducing the need for antibiotics. Follow my top tips for supporting your immune system:

Eat plenty of fruits and veg that are rich in vitamin C such as blueberries, oranges, carrots and rosehips. Find out more about boosting your immune system with diet here
Keep your home clean and mould free. Check out Ecover’s range of cleaning products to keep your home free from harmful bugs without the harsh chemicals
Wash your hands! This is especially important when you’re out and about during the winter as bugs can be found everywhere from door handles to keyboards
If cystitis is your problem the most important thing you can do is drink plenty of water daily to prevent stagnant urine sitting in the bladder for too long. For more information, read our article on ‘Why do I keep getting cystitis?’
Take a herbal remedy such as Echinaforce daily to keep the immune system strong
Look after your digestion. Without good digestion you won’t be able to break down food properly or absorb all those important nutrients. Eating a healthy diet full of fruit, vegetables, pulses and complex carbohydrates such as brown rice, wholemeal bread and quinoa will look after your gut, and a probiotic and prebiotic can help too!