Medical experts in the UK have called for doctors to stop instructing patients to complete courses of antibiotics as they believe it’s contributing to the superbug endemic.
Contrary to what doctors have been saying for more than half a century, in most cases, failing to take an entire course of antibiotics does not increase the risk of common forms of infectious bacteria developing resistance.
Most of us have been to the doctor with a sore throat or earache that just won’t go away and have been given a course of antibiotics with the sage direction to take all the tablets, even if you start to feel better. Even the World Health Organization (WHO) supports the idea that stopping antibiotics too early could give the remaining bacteria a helping hand.
However, the problem with this type of advice is that it has never been proved by any kind of research, instead arising out of an early hypothesis proposed by Howard Florey, an Australian pharmacologist, who in the early 1940s carried out clinical trials on the newly discovered bacteria-killer, penicillin.
Florey’s team managed to extract only 4 grams of the compound from the mold Penicillium chrysogenum – enough for one day’s worth of treatment. To test its therapeutic effects, they injected the substance into a patient, who had developed a nasty Streptococcus pyogenes infection.
Over the following 4 days, the researchers recovered what penicillin they could from Alexander’s urine, and they continued to treat him with slowly decreasing dosages. Unfortunately for the patient, it wasn’t enough – the infection initially subsided, only to return and kill him once the drug finally ran out.
It was something of a Pyrrhic victory for Florey and his team, who, despite having lost their patient, established penicillin as a strong contender for a powerful treatment against bacterial infection.
Alexander Fleming, the scientist who discovered penicillin as an antibiotic compound in the first place, had long realized that bacteria could become acclimatized to the substance’s toxicity. He famously claimed during his 1945 Nobel Prize in Physiology or Medicine acceptance speech, “If you use penicillin, use enough!”
These early examples of the possibility of leaving behind resistant bacteria, and a patient who died after too brief a course, have biased medical intuition ever since, encouraging patients to take more antibiotics than is needed to treat common infections.
On the other hand, there are cases where nuking an infection is important. For example, agents that are infection professionals, such as Mycobacterium tuberculosis and Salmonella typhi, or even non-bacterial pathogens such as HIV and the parasites responsible for malaria, can spontaneously mutate into resistant forms.
Once the rest of the infection is cleared, these infectious forms can still remain. Therefore, combinations of drugs are needed to destroy all forms of these deadly microbes, and failure to follow courses to the end could increase the risk of resistant forms spreading through a population.
The common infections that give us sore throats, urinary tract infections, and inflamed cuts aren’t so much as professionals as opportunists that commonly live inside our bodies and jump the fence when the grass looks greener. Among the billions of microorganisms that constantly inhabit our bodies there are a handful that already possess some degree of resistance to antibiotics.
Here lies the problem – a course of antibiotics won’t kill all these microbes, and you should be grateful that it won’t as you need them. For most opportunistic infections, it’s important to destroy only the trouble-makers. More antibiotics in this case, isn’t going to be better, as the longer opportunistic bacteria are subjected to antibiotic exposure, the greater the pressure to select for antibiotic resistance.
The spread of drug-resistant “superbug” pathogens are a huge concern in today’s society, where misuse of therapies such as antibiotics has helped make resistant strains more common.
So what’s the new message? Well, even the researchers admit that there needs to be more studies carried out on what constitutes a more effective instruction. However, the most appropriate simple alternative message is to stop when you feel better.
Source: sciencealert
Images: depositphotos
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