‘Must I take all my antibiotics?’ Why infectious disease experts are rethinking this longstanding rule

Infectious disease physicians are revisiting the long-standing instruction to always finish a full course of antibiotics, a rule the CDC and WHO promoted based on a belief that stopping early breeds resistant bacteria. Researchers now say there's little evidence for that specific claim; strep throat, for instance, has never developed penicillin resistance despite decades of relapses. What actually drives resistance is exposure itself — the longer antibiotics are taken, the more they disrupt the body's microbiome and give resistant bacteria room to thrive.

Clinical trials over the past decade on bladder infections, pneumonia, and bloodstream infections have found shorter courses often work as well as longer ones, with fewer side effects, shrinking many prescriptions from 14 days to three or seven. But complicated infections, abscesses, or weakened immune systems can still require extended treatment, and there's little research yet on using symptom improvement alone as a stopping cue. The bottom line remains, somewhat anticlimactically, to follow your doctor's advice.

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