Spot the Urban Legend

“Sigh. This urban legend about taking every last dose must stop. Who is spreading this malarkey?”

That was the response yesterday of @BradSpellberg, Chief Medical Officer of the Los Angeles County-University of Southern California Medical Center, to the NBC News headline, below, concerning a countrywide outbreak of a drug-resistant bug.



The problem, of course, isn’t with the hand washing. It’s with the idea that you must take every antibiotic pill in your prescription. Dr. Spellberg is one of the leading proponents of the new thinking that “shorter is better.” He explains:

“Every randomized clinical trial that has ever compared short-course therapy with longer-course therapy … has found that shorter-course therapies are just as effective … This myth needs to be replaced by a new antibiotic mantra: ‘Shorter is better!’ Patients should be told that if they feel substantially better, with resolution of symptoms of infection, they should call the clinician to determine whether antibiotics can be stopped early. Clinicians should be receptive to this concept, and not fear customizing the duration of therapy.”

This new thinking is predicated on the understanding that antibiotics, while sometimes necessary and even lifesaving, come with serious side effects. Spellberg:

“Antibiotics are harmful. They’re not this thing that magically cures disease and has no unfortunate side effects – that’s not real. Antibiotics have lots of problems associated with them: They breed out resistance. They breed out superinfections like C. diff [an antibiotic-driven bacterial infection] and Candida [a fungal infection]. They cause side effects.”

For further information on adverse side effects associated with antibiotic use, see here and here.



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