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‘Finish Your Antibiotics’ is Outdated Advice

‘Finish Your Antibiotics’ is Outdated Advice
February 24
04:45 2017

(HSI) — It’s one of the oldest and most often repeated pieces of medical advice: Finish up your entire course of antibiotics!

You may not believe it, but that long-held belief is based on an idea over 70 years old that became so entrenched, no one even bothered to take a second look.

Until now.

What some maverick researchers are daring to say is that idea is wrong, wrong, and wrong.

And it’s more than just bad advice. It’s something that’s doing us more harm than good.

The new norm

At the time doctors came up with the idea that a course of antibiotics had to be completely finished (even if you feel all better), Bing Crosby and Perry Como topped the hit parade, gas cost around 11 cents a gallon and you could buy a new car for under $1,000.

It’s great to relive the good old days — just not where drugs are concerned!

Times have certainly changed, but you’ll still hear the same, stale words of advice from your doctor, nurse, pharmacist and everyone else!

You won’t, however, be hearing it from Dr. Louis Rice, who’s chairman of the department of medicine at the Warren Alpert Medical School.

As Dr. Rice likes to tell colleagues, that advice “never made any sense” 70-plus years ago, and it “doesn’t make any sense today.”

The idea behind it, as every mother knows, is that if you stop taking your antibiotics when you feel better, any surviving bugs will regroup, strengthen and can make you sick all over again.

But here’s where that advice goes off the rails.

Many infections can be successfully treated with much shorter courses than are typically given. Doctors devised what we do now by figuring out just how long was needed to treat any particular infection, then adding some extra time just to be on the safe side.

Although we now know how sparingly antibiotics need to be used, that advice still hasn’t budged an inch. As Dr. Brad Spellberg, an infectious disease specialist says, the concept is “baked into (our) culture.”

And all those decades ago when antibiotics first entered the scene, “superbugs” and “antibiotic-resistant bacteria” weren’t in anyone’s vocabulary. Today, however, even kids in grade school are learning about antibiotic overuse.

We now know that the more we expose bacteria to antibiotics, the “smarter” they evolve, and the harder they are to kill. And experts believe that in the next few decades, superbugs will be killing 10 million people a year.

So, when Dr. Rice and others talk about doctors changing the way they prescribe these drugs, it’s more than just good advice — it’s something that will be saving lives.

Which brings us to the $64,000 question. How do you know if you should stop your taking antibiotics before the bottle is finished?

Numerous studies are now trying to figure that one out. Over the years research funded by the National Institutes of Health has found that we’re typically taking antibiotics much longer than needed. Many courses can be significantly shortened, and some even cut in half.

Even the CDC is now conceding that there are likely many situations in which antibiotics should only be used “until the patient gets better.”

Experts say that treatment times will depend on individual patients — how old they are, how efficiently they metabolize drugs and how well their immune system is working. But these are things your doctor should be taking into consideration and talking to you about.

That’s why Dr. Spellberg advises that you check back with your doctor before stopping any antibiotics early. And if he “won’t get on the phone with you for 20 seconds, you need to find another doctor.”

“Why your doctor’s advice to take all your antibiotics may be wrong” Helen Branswell, February 9, 2017, Stat,

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