Every now and then, I get questioned by friends and family asking whether or not it is necessary to finish the course of antibiotics prescribed to them. My instinctive response to that question would be an unambiguous YES, just as any other person who has medical background would answer.
But when I pause and ponder just a little deeper, I’ve come to realize there really is no definite answer to that question, since no one knows the exact quantity of antibiotics needed to ensure bacteria eradication. After all, the antibiotic course of duration is really subjective to physician’s astuteness and experience.
The conventional advice from doctors to their patients is to finish the course of antibiotic therapy, HOPING that by the end of the course all harmful bacteria would’ve been cleared from the body. But personally, I doubt the difference of day or two from the total course of duration would result in a higher chances of bacterial resistance development.
I really want to look at the conundrum from a different perspective to justify what I’ve just said. For a healthy person with intact immunity, it makes sense to think just a certain dosage of antibiotics albeit one that is lower than full course of duration will suffice to weaken the strength of bacteria. The rest should really just be taken over by the host immune system. Unless the host’s immune system is already compromised to begin with due to concurrent diseases like AIDS or Tuberculosis, the answer to this ultimate question is very debatable in my opinion.
Not only does long term antibiotic treatment impose unnecessary mental stress to patients, it also causes significant disruption to the body normal flora, rendering it to secondary infection. A classic example is the Clostridium Difficile colitis. This strain of bacteria normally doesn’t cause harm to the host body, until antibiotics starts destroying harmless gut flora, leaving it without trophic competition. With such tremendous dynamic change in gut flora, it isn’t surprising to see some people develop celiac disease or become lactose intolerant after finishing their antibiotics regime. I talked about it in my previous post here.
Personally I can attest to the physical discomfort and side effects caused by taking Flagyl (also known as Metronidazole) in a 10 consecutive days treatment (together with other medications). The size of one Flagyl pill is as big as the distal phalanx of my index finger. It gave my hind throat a “metallic” and pungent taste throughout the course, by the 4th day the thought of giving up was already creeping in. I felt groggy and nauseous every day after taking it and the sensation would last up to 6 hours. By the 7th day I noticed the back of my tongue was coated with a white layer of cell debris as a result of taking the antibiotics. Fortunately I managed to forced myself through until the end. It wasn’t a pleasant experience, to say the least.
I think there should be a tipping point to duration of antibiotic therapy. That being said, it shouldn’t be so long that it starts causing physical discomfort but long enough to weaken the bacteria and let the body’s immune system do its own job. Also, according to a clinical study done by National Center of Biotechnology Information (NCBI), results showed no significant difference in clinical cure among patients receiving shorter vs longer duration of antibacterial therapy. In fact, there is even a research that shows the rate of antibiotics resistance development is proportional to the amount of antibiotics used. You can check it out here. But in some cases, inadequate quantity of antibiotics really does risk patient’s life especially in life-threatening condition, just like what I mentioned in previous post regarding the death of Albert Alexander.
All in all, the question is really too complex to be justified with a single answer. There needs to be more research done with more promising evidence before anyone can confidently make a conclusion on this issue.
Question: Do you finish the course of your antibiotic all the time? Leave a comment down below and let me know, thank you for reading.