“The idea that stopping antibiotic treatment early encourages antibiotic resistance is not supported by evidence, while taking antibiotics for longer than necessary increases the risk of resistance,” the authors wrote.
It depends on the bug — tuberculosis, they point out, can become resistant if exposed to less than the full course. But many illnesses today are caused by bacteria like E. coli and Staphylococcus aureus that make you sick if they get into your blood stream or gut, but are harmless and common on your hands. The group argues that these bugs are more likely to become resistant if you take more antibiotics than you need.
Similar arguments appeared in a Lancet article titled “Don’t keep taking the tablets” as early as 1999.
All agree that more research would help settle the question. In the meantime, if you’re tempted to take less than the full antibiotic dosage, your best bet would be to ask your doctor when you first get the prescription or call back before you stop. Keep a record of symptoms like pain or fever and your history with antibiotics. As the British group notes, the correct antibiotic dosage for you may not be the same as for someone else.
As part of the fight against resistant bacteria, the Food and Drug Administration has cut back on how much antibiotics farmers should give livestock, in new recommendations that went into effect this year to counteract antibiotic resistance. The United States is now in line with a European Union guidance from 2006.
March 31, 2020
Christopher Nystuen, MD, MBA