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The shortest course is bad advice. When you do take antibiotics, you don't want to create antibiotic resistant bacteria.
That's why they tell you to always take the full course, even if you feel better.
tl;dr - Asking your doctor for the shortest reasonable course is a good thing that will both protect you as a patient as well as minimize your risk of antimicrobial resistance. But the key phrase is ask your doctor, do not take it upon yourself to decide when to stop them. Take whatever course you're prescribed.
Pharmacist and 4th year medical student with a passion for antimicrobial stewardship and infectious disease.
Historical treatment duration for most infections was truly quite arbitrary. Evidence for most infections, when it is actually tested, have pretty consistently demonstrated shorter treatment durations than were classically taught (10-14 days for pneumonia now generally 5-7, 14 days for Gram Negative Bacteremia now 7, etc). There is a subset of infectious disease doctors that are bucking the trend of historical "you have to complete your course advice" for some infections. In general, what I have seen is recommendations to discontinue antibiotics with significant clinical improvement AND a non-life-threatening infection in a non-sterile body cavity. So nobody is shortening course durations for empyemas or endocarditis.
The issue becomes expecting patients to know what constitutes clinically meaningful recovery and whether or not their infection is one of the "safe" ones to stop antibiotics earlier.
At the end of the day, I totally disagree with your premise, as we should always strive for the minimum safe antimicrobial exposure. However I do agree that telling patients "shorter is better" is bad advice because I don't want laypeople making these decisions when usually no-ID physicians don't make them.
That's wrong. Stop confidently spreading harmful misinformation. I already provided citations that you should have checked before making that statement: https://humanmicrobiome.info/antibiotics/
EDIT: And to all the people who upvoted the person I’m responding to, you should not be upvoting people who make medical/scientific claims without a citation, especially when they’re contradicting a highly reputable news source (NYT) that contains scientific citations and expert commentary.
The real information is to ask your doctor and be careful with advice from social media.
Yes and no. https://forum.humanmicrobiome.info/threads/doctors-are-not-systematically-updated-on-the-latest-literature-what-t.27/
That is not a website doctors look at. Medical procedures are formed and approved through NIH articles with vast testing pools across many geographical areas.
If you would like more info, please look up the IDSA guidelines
Wrong. Also irrelevant. It contains a plethora of scientific citations, which is all that matters.
Gibberish that tells me you don't know what you're talking about, but want to sound authoritative.
I’m letting you know that those links are all to small journals. Good luck getting huge corporations to follow that advice versus tried and true advice. I rather a patient live than risk the infection returning and killing them.
It’s not invalid but until IDSA adopts any of that… it’s not medical advice for anyone, just research.
I would like to point out, the NYT is a reputable news site but cannot even remotely be trusted with medical information/recommendations. I can't tell you the last time I read a medical news piece from any source (and the NYT is the primary place I get my news) that I couldn't read it and say "well that's a gross oversimplification" or worse "this is blatantly misrepresenting the scientific author's conclusions". Holding up the NYT as a source of medical/scientific truth is just demonstrating how scientifically illiterate you really are.
Wow, projecting hard with that comment. This is a fantastic and well-cited article, and your comment does nothing to debunk anything in it, and you end with a baseless "you're scientifically illiterate" comment. Amazing.