Antibiotics: drink until the end?

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Each of us had heard from the doctor: do not stop taking the antibiotic until, until the end of the pack, even if you feel improvement. The rationale for this instruction was always the same: too early termination of treatment will cause the development of antibiotic resistance — the ability of the pathogen to resist the medicine. For decades, we listened to the statement that treatment with these drugs should undergo a full course. Now, however, more and more experts say that this approach, in contrast, can lead to the development of antibiotic resistance. This issue is devoted to material Helen Branswell in the edition Stat.

The scheme is simple: the effects of antibiotics encourages bacteria to develop a resistance. Medications at the moment when you’re not ill, gives to the hordes of bacteria inside your body (and on it) more incentive for the evolution and for resistance to drug action, so that next time when you get infection, it might not work.

STAT quoted Professor of medicine from brown University Luis rice: “the Traditional argument doctors never made sense. And today it does not make sense”. Many colleagues consider him to be rice’s first person who said that the king is naked: and indeed, he expressed doubts of the correctness of the notorious medical Council in 2007 and 2008 at the meetings of the physicians.

The question of relevance, the Council does not stop immediately after improving to take antibiotics will be raised at the meeting of the world health organization in Geneva. In prepared to the meeting report has already noted that this recommendation is not supported by scientists.

In many cases “it is reasonable to stop antibiotics immediately after the doctor has ruled out bacterial infection or when the symptoms of mild infection was gone,” says the report.

It is important to realize that no one doubts the saving function of antibiotics — they kill bacteria. However, the longer the bacteria are exposed to drugs, the stronger they become. And what fitter they become, the harder it is to deal with them.

The concern is the fact that a growing number of bacteria that are resistant to various antibiotics, will lead to an increase in the number of untreatable infections — which in turn will result in the fact that many medical procedures of the hip joint prosthesis or of open heart surgery cannot be performed without risk to the life of the patient.

How did it happen that an incorrect installation is entrenched in medical practice? The answer lies in the 1940-ies — beginning of the use of antibiotics. Resistance to the drug then nobody cared. After the invention of penicillin from the womb of pharmaceuticals began to erupt all new medicines. The doctors were focused on one thing: how to effectively use medications to save patients ‘ lives. Formed a scheme to treat patients until until it becomes better and even for some time — just in case. Around the same time, studies have found that untreated TB has the ability to return.

Sometimes doctors prescribe antibiotics, guided by its experience and intuition. There are guidelines for the treatment of various infections, but many of them do not include information about how long you should continue treatment. In addition, the response to treatment differs from patient to patient depending on age, immunity and so on.

It is obvious that pharmaceutical companies have no special motivation to conduct expensive research on this subject. But the national institutes of health has funded a number of such studies, and almost all of them found that many infections can be cured faster than was supposed earlier.

Doctors and health agencies are now in a difficult position. How to put into practice the new approach? Doctors know that some patients voluntarily stop taking antibiotics when feel better. But it’s not the best way in many situations — for example, it is impossible to deal with the TB or bone infections.

Director of the American Center for disease control and Laurie Hicks commented on the problem in a letter edition of the Stat: “This is a tricky question. Unequivocal statements on the subject can be done, and the simple answer to the question is no. There are diagnoses which can reduce the course of treatment with antibiotics is not recommended or may even be dangerous. On the other hand, it is obvious that there are also many situations where treatment with antibiotics is often appointed for a longer period than it really needed, and then the optimal duration to stop taking, when the patient will be better.”

Specialist Medical center of Minnesota James Johnson commented on the issue: “In fact, we often give patients the following statement: see, I give you a prescription for a week. Most likely, you should take it for three days. If after three days you feel better, stop taking. If not, have a cure is still some time. However, once you become feel good, stop taking the drug”.

And the situation is ambiguous, one is obvious: in making any decision about taking or discontinuing any medication you should always consult with your doctor.

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