The Editorial Executive Committee welcomes letters, which should be less than 250 words. Before a decision to publish is made, letters which refer to a published article may be sent to the author for a response. Any letter may be sent to an expert for comment. When letters are published, they are usually accompanied in the same issue by their responses or comments. The Committee screens out discourteous, inaccurate or libellous statements. The letters are sub-edited before publication. Authors are required to declare any conflicts of interest. The Committee's decision on publication is final.
Letter to the editor
Editor, – In the article 'Antibiotic prescribing: how can emergence of antibiotic resistance be delayed?' (Aust Prescr 2004;27:39-42) I note the emphasis on using these drugs for the shortest time possible. Is it time to change our advice to patients to 'make sure you complete the course, even if you feel better after a few days'?
The reason for this advice appears to be twofold. Firstly, the infection will recur if incompletely treated. Secondly, the emergence of resistance is facilitated by shorter courses of antibiotics, presumably because relatively resistant strains of the pathogenic bacteria may still be viable at the end of such a course. However, is complete eradication of the pathogen desirable or necessary in the clinical world of bacterial tonsillitis, severe otitis media, bacterial sinusitis, bacterial gastroenteritis, urinary tract infection, impetigo and chest infection? Do we actually have any evidence relating duration of antibiotic courses, emergence of resistant pathogens, and clinical 'cure' in these conditions?