Experts call for scrapping of antibiotics 'complete the course' message

Experts writing in The British Medical Journal (The BMJ) argue that the "complete the course" message for some antibiotics needs to come to an end. Julien Behal/PA Wire
Experts writing in The British Medical Journal (The BMJ) argue that the "complete the course" message for some antibiotics needs to come to an end. Julien Behal/PA Wire
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Long standing doctor's orders to always "complete the course" of prescribed medicine should be DROPPED to protect against antibiotic resistance, suggests a new report.

Researchers say it is now time to drop the "complete the course" message for antibiotics as it is not backed up by evidence and should be replaced.

They argue that the "deeply embedded" message that patients should "complete the course" of pills to avoid antibiotic resistance has had its day.

In fact, patients are put at unnecessary risk from antibiotic resistance when treatment is given for longer than necessary - not when it is stopped early, according to Professor Martin Llewelyn at Brighton and Sussex Medical School and colleagues.

They say in The BMJ that it's time for policy makers and doctors to drop the message and state that it wasn't evidence-based and is incorrect.

Experts say that antibiotics are vital to modern medicine and antibiotic resistance is a global, urgent threat to human health.

Public communication about antibiotics often emphasises that patients who fail to complete prescribed antibiotic courses put themselves and others at risk of antibiotic resistance.

But Prof Llewelyn says 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.

He suggests that one reason it may be so resilient is that it is simple and unambiguous, and the behaviour it advocates is clearly defined and easy to carry out.

But there is evidence that, in many situations, stopping antibiotics sooner is a safe and effective way to reduce antibiotic overuse.

He said there are notable exceptions for some types of antibiotic, such as those used to treat tuberculosis.

Prof Llewelyn said: "Completing the course also goes against one of the most fundamental and widespread medication beliefs people have, which is that we should take as little medication as necessary."

He and his colleagues called for research to determine the most appropriate simple alternative messages, such as stop when you feel better.

Prof Llewelyn added: "The public should also be encouraged to recognise that antibiotics are a precious and finite natural resource that should be conserved by tailoring treatment duration for individual patients."

His team said clinical trials are required to determine the most effective strategies for optimising duration of antibiotic treatment.