Do you really need to finish all your antibiotics?

pulse

February 16, 2017 1:20 PM

Doctors give this advice because the conventional wisdom is that stopping too soon can lead to antibiotic resistance.

Antibiotics

A new report questions the tried-and-true advice

It’s a health guideline as ingrained as covering your mouth when you cough or washing your hands after going to the bathroom: When you’re taking antibiotics, you need to finish the whole pack - even if you don't have symptoms any longer.

If you don’t completely wipe out the bugs, your condition can re-emerge worse than before, and you’ll have to take even more antibiotics to combat it.

But some experts are pushing back on that advice.

In a recent report about antibiotic awareness campaigns prepared for the World Health Organization, researchers note that an argument can be made for stopping antibiotics when the signs and symptoms of an infection has disappeared—even if you still have some pills left to take.

Continuing antibiotics through the full course of pills can put you at higher risk for developing an allergic reaction, kidney damage, blood cell damage, or liver problems, says Louis Rice, M.D., chairman of the department of medicine at the Warren Alpert Medical School at Brown University.

Exposure to antibiotics is what drives bacteria to become resistant, Rice says. When you keep taking the drugs unnecessarily - say, if your infection is already take care of - it gives bacteria more time to learn how to evade the drugs. And that sets you up for antibiotic resistance in the future.

“The longer an antibiotic is given, the more likely that the resistant bug will predominate, primarily in the gastrointestinal tract and the skin,” says Dr. Rice.

When that happens, the resistant bug is more likely to spread, especially in hospitals where there are other people who are on antibiotics and may have compromised immune systems.

But that doesn’t mean you should ditch your meds as soon as you feel better, he emphasizes. There are some infections - like strep throat, Legionnaires disease, and tuberculosis - that need the full course of antibiotics to be knocked out.

For others, though, Dr. Rice recommends talking to your doctor.

“Generally, if you feel better, it suggests that your immune system has gotten the infection under control,” he says.

“There is no one size fits all here.”

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