We welcome the debate sparked by your article (Keep taking the tablets? Antibiotics rule could be wrong, 27 July). The British Society for Antimicrobial Chemotherapy (BSAC) is keen to safely reduce the overall use of antibiotics, given that “overuse” is helping to drive the alarming rise in so-called superbugs.
We, like others, suspect that a significant number of antibiotics are being prescribed for longer than is necessary. However, the idea that patients should stop taking antibiotics “when they feel better” is too subjective and risks treatment failure or relapse. Most patients simply will not know if the cause of their infection has been eradicated – or not. Two things need to happen urgently: research to identify (1) all those infections that do not need to be treated with antibiotics, and (2) the most effective length of treatment for those infections that do.
For these reasons, we cannot currently support dropping the message “complete the course of antibiotics” because the evidence in support of it is sparse and the advice is potentially confusing. We also need a robust assessment of the harm that stopping antibiotics early might cause in higher-risk or vulnerable patients. Doctors and patients should always discuss the pros and cons of antibiotics and, if prescribed, what course length is appropriate. For that reason, BSAC recommends that the message to the public should remain: “Follow the advice of the healthcare professional.”
Dr Gavin Barlow Infectious diseases consultant, Dr Nick Brown Consultant medical microbiologist, Philip Howard Vice-president of BSAC, and consultant antimicrobial pharmacist, Professor Dilip Nathwani President of BSAC, consultant physician, and honorary professor of infection, Professor Laura Piddock BSAC chair in public engagement, director of Antibiotic Action, and professor of microbiology
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