Finishing your antibiotic prescription could finish you off

According to the CDC, 1 in 3 antibiotics prescribed in the U.S. are unnecessary. Doctors wrongly prescribe them for viral infections — like colds or the flu. Antibiotics only should be reserved for serious bacterial infections.

But even if you have a serious bacterial infection that requires antibiotics, you may want to disregard your doctor’s advice about how long to take them.

Doctors typically tell you to keep taking an antibiotic for the entire length of the prescription ­— until the pill bottle is empty — even after you have fully recovered.

But new research questions whether this nearly century-old medical mantra belongs in the category of medical myth. Turns out, following this knee-jerk practice may have done more harm than good over the years.

Outdated medical advice contributes to development of superbugs

We already know that the growing numbers of antibiotic-resistant bacteria (so-called “superbugs”) cause more and more incurable infections.

Plus, if you keep taking antibiotics when you aren’t sick anymore, it simply gives bacteria in and around your body more opportunity to develop resistance. (I call that turning “magic bullets” into “friendly fire.”)

Then — the next time you need to take an antibiotic, it may no longer work. It reminds me of an old tag line for a common remedy that does work, Alka-Seltzer, “I can’t believe I ate the whole thing!”

According to Dr. Louis Rice, Chairman of Medicine at Brown University Medical School, the practice of finishing the whole pill bottle, “never made any sense. It doesn’t make sense today.”

Professor Rice began questioning the dogma about how long to prescribe antibiotics at professional meetings in 2007 and 2008. Now, 10 years later, some physicians and researchers are beginning to pay attention.

The World Health Organization (WHO), which never saw a modern drug, vaccine, or medical technology it didn’t like, has prepared a report for a meeting this month in Geneva. The WHO’s expert committee notes that science never backed this old recommendation.

The WHO report says, “an argument can be made for stopping a course of antibiotics immediately after a bacterial infection…or when the signs and symptoms of a mild infection have disappeared.”

How did we let them get us into this mess?

Starting back in the 1940s, the new miracle drug of penicillin led to a flood of antibiotic drugs. Doctors were only concerned about learning how to use the drugs effectively to save lives.

This generation of physicians (the ones who originally taught me) was impressed by their new-found ability to save lives. They were also still traumatized about all the lives lost to infections before the arrival of penicillin.

So, just to be safe, they always treated patients longer than needed, just to be sure that the infection would not come back. But they didn’t have any real research or evidence to support that practice.

Of course, the real secret is that by the time an antibiotic “works,” it is really because your immune system has fully kicked in. Antibiotics just help your body catch up with a bacterial infection, so your immune system still has to do the real work of clearing a bacterial infection.

Giving more antibiotics than needed became baked into medical culture, based only on belief. (And it was relentlessly baked into my head too during the 1970s and 1980s — a mantra I myself had repeated.)

They like us to think that medicine is a science guided by research. And there are treatment guidelines for different infections, but many provide scant evidence on how long to continue treatment.

Of course, drug companies (together with the basic research done for them at NIH, provided by the taxpayers) sponsor most modern medical research. Big pharma has had little reason to conduct expensive studies to determine the least treatment needed for various infections.

What little research has been done in the past 10 years invariably shows that infections can be cured more quickly than thought. Two-week treatments should be cut to one week. And 10 days of treatment is better done in five days.

Never one to let real science get in its way, the CDC and its “Get Smart” Campaign continues to spend your dollars to “educate” you on antibiotics. They still say never skip doses or stop the drugs just because you are feeling better. (That is, just because your immune system has fought off the infection.) These approaches continue to create more antibiotic-resistant superbugs and incurable infections. It must be good business (for CDC and their crony capitalist co-dependents).

But you don’t need worry about common sense getting in the way of your government public health career. If your doctor prescribes an antibiotic, you can stop taking it when you feel better, and check back with him or her.

Dr. Rice tells patients, “As soon as you feel fine, stop. We [doctors] can give permission to do that…If your doctor won’t get on the phone with you for 20 seconds, you need to find another doctor.”

 

Sources:

“Why your doctor’s advice to take all your antibiotics may be wrong,” (www.statnews.com) 2/9/2017

“CDC: 1 in 3 antibiotic prescriptions unnecessary,” Centers for Disease Control (www.cdc.com) 5/3/2016


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