Every time I've filled a script for antibiotics, they have been accompanied by very prominent written warnings that you must complete the full prescribed course. Often reiterated verbally by the pharmacist.
But has the warning ever said why you should complete the course? I always assumed (until recently) this was to prevent reinfection, not resistance.
Stern warnings with no information about possible consequences is heavily lambasted in movies, yet we repeat this behavior with medicine and expect different results.
If you tell someone not to do something and don't tell them why not, and the consequences aren't otherwise clear, expect them to do what you said not to do.
Was going to say the same thing. My doctors have always told me to finish the prescription, but never once why.
My mother was a nurse so she always reminded me of the critical missing reason why, and I've always dutifully finished all antibiotics prescriptions as a result.
But that was a simple thing the doctors writing the prescription should have been doing themselves, and an apparent systemic failure of the medical profession to account for messy human psychology in a critical procedure.
It astonishes me that people would be prepared to acquiesce to authority when a doctor tells them to ingest these drugs that they really know very little about, but draw the line at accepting the advice about taking the whole course of drugs.
Most doctors dont have the types of antibiotics memorized by heart either unless they work in a specialty or ER. There are cell wall destroyers, folic acid synthesis interruptors, protein synthesis disruptors, etc. [1]
Gone are the days where a doctor should be taken at his judgment 100% as if medicine is a black box enigma. The average HNer would be wise to google about their conditions and drugs they consume. A doctor can only remember so much - they are primarily valuable for their experience in hueristic diagnosis -- not for knowing everything medical and everything pharmacutical. It is wise to relinquish some responsibility to a professional but not all.
Most of medicine aside from surgical methods can be understood by a mildly intelligent person who cares enough, because of wikipedia and google, everything except actual experience is very accessible.
I dont see how your astonishment is anything other than misinformed hyperbole.
People will take all kinds of advice when they're trying to feel better but once they feel good, they want to get back to partying ASAP and the doctor says no drinking while taking antibiotics.
TL;DR - In the early days of penicillin, it was used to treat various STDs. Doctors strongly advised their patients that alcohol was not to be consumed while taking the anti-biotics, not because there was a chemical interaction between the medicine and the infection, but to lower the odds of the patient getting wheeled one night and re-infecting themselves.
I think another factor is just intuition: taking medicine when you feel ill makes sense, but continuing to take the medication for several days after you feel completely recovered seems intuitively wrong to a lot of people.
Yep, you're intelligent enough to make the correct assumption. Unfortunately, I presume many others are not and could really use a little extra education by the pharmacist dispensing meds -- so they also understand the why.
Not the ones that I've encountered... they used the same dose at the same intervals for the whole period of time... maybe to keep a lethal level in your system the whole time.
I definitely remember receiving blister packs, decorated with directions and pill groupings that started with 2 pills, at high intervals like every 6 hours, then tapered to 2 pills every 12 hours toward the end of the first week, then 1 pill every 12 hours for the remainder of the pack, and included strict instructions to use the whole thing.
I got strep throat a few times as a kid. I don't have perfect recall about the details of what I had to take and when or why, though. But I do remember having to vary dosage.
Exactly this. If it's so vital that we finish the dose, why don't you make a bigger deal out of it? I feel that doctors simply don't care enough. Is there any other explanation?
This is actually typical bad parenting or poor management. Whilst orders without explanation work in the army through absolute discipline, it doesn't work very well with people who haven't been conditioned to it.
Given an instruction when you don't understand the "why" is highly ineffective. As seen by your experience with your doctor.
There is also a further problem in that antibiotics treat not just you, but prevent infection in the wider population. People in general find it hard to think about the wider impact, which is something we see every day with regards to the world wide population's regards to the impact of their own pollution. It's why we recycle but then drive SUVs.
I just got a course of antibiotics, so I asked why should I finish it (because it said so on the package)? The answer from the lady of the medical staff: otherwise the inflammation would come back.
But they don't explain why, and warnings are overdone due to litigation fears, so people will often use their own judgment, and without understanding the concept behind why, they may choose unwisely.
"Take all of the prescribed medication" : "They're just greedy and want to make me buy more"
vs.
"Take all or you'll breed antibiotic-resistant bacteria that cannot be treated and you will die and kill the human race" : "I better follow this prescription"
If you're the sort to believe it's just a conspiracy to make you buy unnecessary quantities of drugs, then why wouldn't you also presume that the story about antibiotic-resistant bacteria is also part of the conspiracy?
Because the scale isn't binary here - you don't have only a) people who blindly trust doctors, and b) people who are conspiracy nuts.
Both of them are wrong, btw. Pharma companies are greedy and they do everything they can to make you spend more. Doctors are influenced by them, often very subtly. That is a fact, not a conspiracy. But the fact also is, that doctors save lives and most have noble intentions (despite the meat grinder medical career is). One needs to learn what information belongs more to "greedy companies" category, and what belongs to "life saving science" category. It's no surprise people get confused about this - and that's why you absolutely need to explain to them why they need to finish antibiotics treatments.
"they have been accompanied by very prominent written warnings that you must complete the full prescribed course"
I'm ashamed to admit that the big part of my adult life I didn't know the reason behind that, and always assumed that to be of a kind "you must eat your whole meal" constantly told by grandma. I'm sure I'm not the only one..
Oh my god the number of arguments I've had with family and friends, even my girlfriend over this. Why do people think they can stop antibiotics when they "start getting better"?!? It's not a virus ffs
Probably because they have no clue how they work, and they don't have a good mental model of diseases and bacteria. Aka. they don't understand the "why". A bit of explaining would definitely help.
I agree with the observation that telling people to do something without explaining why is stupid and will only lead to disappointment.
yeahhhh I thought it was just because although you feel better you could still be in part of the infection cycle, not because the remaining germs were probably now resistant.
