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Skipping Meds: Why should I finish my course of antibiotics?

January 31st, 2017 by Stephanie Hall

As many as 444 million working age adults are expected to die from conditions relating to antimicrobial resistance (AMR) by 2050, according to a report from Rand Europe.

A statistic like that is terrifying and it should make us listen more closely to the experts telling us that we need to start a worldwide ‘revolution’ if we want the human race to stand any chance of existing for another two hundred thousand years. (Not all of us celebrate the coming of an imminent zombie apocalypse.)

The time has finally come for us to start thinking about antibiotics more seriously, and in order to do this, I’m going to go through the steps we need to take in order to avoid World War Z. I’ll start by talking about what can happen to us as individuals if we fail to finish a course of antibiotics and then I’ll work my way up to the worst case scenario: oblivion.

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What happens to me if I don’t finish my course of antibiotics?

The simplest answer to this question is that your symptoms will continue to bother you.

Given enough time, bacteria will adapt to changes in their environment. So if you cut off your medication cycle prematurely, you’re not giving yourself the best chance of eliminating all the infected cells that your antibiotics are intended to treat.

It’s important to understand that bacteria are the bullies of the body playground. They’re not as sinister as their older cousins, the viral infections, but they’ll still leave you gasping for breath at the side of the tarmac. And they’ll certainly take advantage of any opportunity you give them to grow stronger and tougher.

If I feel better, why do I need to carry on taking my antibiotics?

While taking a few of your antibiotics may reduce your symptoms and begin to eliminate the bacteria infecting your body, you won’t be able to fully rid yourself of your complaints unless you finish your antibiotics and destroy all the bacteria you need to.

Echo-NHS-Healthcare-White-Pills-in-Palm

Echo’s clinical director, Alistair Murray, says:

“Taking fewer doses of antibiotic than prescribed by your doctor increases your chances of having residual bacteria left in your system. These residual bacteria may be less susceptible to your antibiotics and therefore need longer exposure for any beneficial effects to take place, else they could develop resistance.”

In essence, feeling better will only be temporary if you don’t finish your antibiotics, so committing to the entirety of your course is essential if you really want to be symptom free.

Is there any such thing as too many antibiotics?

The truth is that a small amount of the friendly bacteria in your system may be killed off if you continue to take antibiotics for longer than necessary.

However, it’s important to remember that any friendly bacteria lost to antibiotic treatment will usually grow back within a few weeks of your antibiotic treatment ending.

Also, your GP is unlikely to ever prescribe you an unsafe amount of antibiotics. So it’s better to just finish the course prescribed to you in order to relieve your symptoms and prevent the growth of any resistant bacteria.

As Echo’s Alistair Murray reminds us:

“If you have serious concerns about the side effects you are experiencing while taking any medication, you should contact a healthcare professional.”

What happens to my other medications?

Some antibiotics can reduce the effectiveness of other medications.

A common example of this is the way in which rifampicin and rifabutin (antibiotics used to treat Tuberculosis) make the oral contraceptive pill less effective.

Contraceptive Pills - Image courtesy of BruceBlaus

The danger with antibiotic interactions, which are unexpected side effects caused by mixing opposing medications, is that they can render your other medications less effective.

Alistair says:

“Interactions between antibiotics and certain other medications can make treatment less effective. Either the antibiotic or the other medication can increase or reduce the concentration of the other medicine in your body, which can stop things working or increase side effects.”

You can visit the website for the British National Formulary to access a full list of medicinal interactions.

Are there any side effects to taking antibiotics?

Timing is incredibly important when taking a course of antibiotics.

You shouldn’t just take the antibiotics prescribed to you for the entire length of your treatment without taking them at the times you’re meant to take them.

Doctors recommend that if you fail to take one of your antibiotic doses at the correct time, and you’re closer to the timing of your next dose than your previous dose, you should skip the missed dose altogether. This is because double dosing can increase your chances of experiencing some of the most common and unpleasant side effects of antibiotics, inclusive of nausea, bloating, indigestion and diarrhoea.

Echo’s clinical director says:

“Unless told otherwise, it's best to spread your doses as evenly as possible to ensure that you have a sufficient and steady level of antibiotics in your bloodstream. Leaving gaps between doses allows antibiotic levels to fall and could encourage bacterial resistance.”

But if you manage to take all your antibiotics at the times you’re supposed to, your chances of experiencing any side effects will fall dramatically.

What is antibiotic resistance?

The World Health Organisation has stated that ‘antibiotic resistance is one of the biggest threats to global health, food security, and development today’.

The actual term antibiotic resistance refers to the immunities that many strains of bacterial infection are developing against the treatments currently used to target and eliminate them. After developing immunities, these bacterial strains have the potential to mutate beyond recognition, and turn into what are referred to as superbugs, which include MRSA, CRE and C.Diff.

Echo-NHS-Healthcare-Testing-Laboratory

Widespread failure to take antibiotics as prescribed is accelerating the rate at which bacteria are developing immunity to antibiotic medication, and if this continues, scientists will soon run out of the antibiotics they use to treat super-resistant microbial infections.

The chief executive of the UK Sepsis Trust, Dr Ron Daniels, told The Bureau of Investigative Journalism that 12,000 people are already dying from conditions relating to AMR each year. This contradicts claims made by the UK government that 5,000 people die from the same conditions.

The worry with all of this, opposing statistics and all, is that thousands of people could lose their lives to AMR infections before scientists are able to develop new treatments.

Avoiding World War Z

If we want to push the end of the world back to a later date than is currently forecast, we need to finish our courses of antibiotics in the way our doctors tell us to.

Taking your antibiotics as your doctor advises will:

  1. Lower your risk of continuing symptoms

  2. Reduce your chances of experiencing side effects

  3. Help prevent interactions with other medications

  4. Slow down antibiotic resistance on a global scale

  5. (Potentially) delay the end of the world

When it’s put to you like that, it doesn't seem like such a bad idea to just finish your course of antibiotics now, does it?

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