Comment by Zeppelin15 | Hacker News Reader

Comment by Zeppelin15 | Hacker News Reader

Parent Full thread

I Heard something controversial on the radio the other day. Don't finish your antibiotic course. Stop when you feel better.

The rational was: Bacteria becoming resistant due to a treatment has only ever been proven for a handful of conditions( TB , HIV syphilis, and so on). The other bacteria are ether resistant or they aren't prolonging the treatment does not encourage a resistant mutation.

By prolonging your treatment with antibiotics you create an environment in which antibiotic resistant bacteria, both the good and bad kind, can replicate easier. Due to Horizontal gene transfer good bacteria can transfer their antibiotic resistance to bad bacteria.

This advice is in stark contradiction to the Fleming quote.

I heard it on the radio and can't remember the sources, but it makes sense to my non medical mind.

*edit added sources.

Found the journal entry if anyone cares : https://www.bmj.com/content/358/bmj.j3418

Article about journal entry : https://edition.cnn.com/2017/07/27/health/antibiotics-course...

Very bad advice- you should either finish the entire course or not take antibiotics at all, otherwise you're gonna help the superbugs along.

Meat production is orders of magnitude more effective at producing antibiotic resistant strains.

It only "makes sense" if you don't understand why you should finish your anti-biotics. And don't know or understand the alternative outcomes outside the reasoning you've proposed.

IE you feel better, aren't better, and risk re-infection.

It's probably much more effective overall to take the guesswork out and follow a consistent routine for each patient. If you give the patient the option to wing it, and they do and that doesn't work, they're not going to take responsibility for it. They'll blame everyone but themselves for a bad outcome.

OF coarse doctors are always going to err on the side of caution, part of the reason for the super bugs in the first place have been given as the over prescription of antibiotics. Not just over prescription in that antibiotics are not needed also the over prescription of duration.

I think the whole feel better approach will help antibiotics resistance not necessarily the patient.

Will be interesting to see the risk of "reinfection vs risk of over prescription" graph.

Horizontal gene transfer thing is what I found really interesting

Found the journal entry if anyone cares : https://www.bmj.com/content/358/bmj.j3418

Article about journal entry : https://edition.cnn.com/2017/07/27/health/antibiotics-course...

Different personal anecdote: you're supposed to finish your course so you don't risk re-infection and yet another round of drugs.

Why are there so many downvotes? There is a journal article linked that questions the common wisdom that failing to complete a prescribed antibiotic course contributes to antibiotic resistance that everyone replying is parroting.

People on this site aren't especially "readers".

Reply on news.ycombinator.com