Cookie use on MRCVSonline
We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive all cookies.
If you would like to forward this story on to a friend, simply fill in the form below and click send.

Your friend's email:
Your email:
Your name:
Send Cancel

Full antibiotic course ‘unnecessary’ - study
NOAH says animal keepers should continue to follow their vet's advice about using antibiotics.
Experts claim stopping treatment early encourages AMR

The time has come to drop the message that patients must always complete a course of antibiotics, according to experts in the British Medical Journal (BMJ).

Writing in an Analysis article, the authors argue there is little evidence to support the idea that stopping antibiotic treatment early encourages antibiotic resistance. In contrast, they claim that patients are put at unnecessary risk from antibiotic resistance when treatment is given for longer than necessary.

‘Research is needed to determine the most appropriate simple alternative message, such as stop when you feel better,’ they write.

‘Until then, public education about antibiotics should highlight the fact that antibiotic resistance is primarily the result of antibiotic overuse and is not prevented by completing a course. The public should be encouraged to recognise that antibiotics are a precious and finite natural resource that should be conserved.’

But the National Office of Animal Health (NOAH) says that animal keepers should continue to follow their vet’s advice about using antibiotics.

“Our advice is always to follow the instructions of the prescribing vet – as to whether antibiotics are needed at all, or if they are prescribed, to complete the prescribed course,” said a NOAH spokesperson.

“Outside of a hospital situation where there is daily monitoring, it is not practical for a farmer or a pet owner to make a subjective judgement on whether the symptoms have improved and treatment should stop, and any confusion over this could leave the door open for resistant bacteria to potentially proliferate.”

BVA junior vice president John Fishwick said that, until further studies are conducted, it is too early to change the way medicines are prescribed.

“Vets should continue to prescribe as previously, only when necessary,” he said. “It is also vital that clients continue to follow the directions given by their vets, both in terms of dosage and duration of treatment, carefully.”

He adds: “The article in the BMJ suggests that antibiotics should be used for as short a period as possible, and that we should move away from the concept of following a predetermined course. This may indeed be a very important advance but it is far too early to determine how this would work in veterinary practice. We need to clearly establish the evidence supporting it.”

Compiled by a collaborative group of experts, the BMJ article states that reducing unnecessary antibiotic use is  ‘essential’ to combat the growing problem of antibiotic resistance.

Together with colleagues, Professor Martin Llewelyn, from the Brighton and Sussex Medical School, asserts the idea that ending antibiotic treatment early encourages the growth of drug resistant bacteria.

He notes that, historically, antibiotic courses were ‘set by precedent, driven by fear of under treatment, with less concern about overuse’.  Today, however, there is growing evidence to suggest that shorter durations may be just as effective.

‘Shorter duration of treatment has been shown to reduce clinical efficacy in a few cases,’ he writes. ‘A notable example is otitis media, where five days’ treatment is associated with a lower clinical cure rate (66%) than 10 days (84%) in children under 2 years.’

The authors conclude that clinical trials are needed to ascertain the most effective strategies for optimising duration of antibiotic treatment.

Become a member or log in to add this story to your CPD history

Newborn okapi named after Meghan Markle

News Story 1
 An endangered okapi recently born at London Zoo has been named Meghan - after Prince Harry’s fiancé Meghan Markle - in celebration of the upcoming royal wedding. Okapis are classed as endangered in the wild, having suffered ongoing declines since 1995. Zookeeper Gemma Metcalf said: “We’re very pleased with how mother and baby are doing. Oni is being very attentive, making sure she regularly licks her clean and keeping a watchful eye over Meghan as she sleeps.” Image © ZSL London Zoo  

News Shorts
Ten new cases of Alabama rot confirmed

Anderson Moores Veterinary Specialists has confirmed 10 new cases of Alabama rot, bringing the total number of confirmed cases in the UK to 122.

In a Facebook post, the referral centre said the cases were from County Durham, West Yorkshire, Greater Manchester, Staffordshire, Sussex, West Somerset, Devon, and Powys.

Pet owners are urged to remain vigilant and seek advice from their vet if their dog develops unexplained skin lesions/sores.