It’s time for a new approach to antibiotics

SIR – Before doctors tell their patients not to complete a course of antibiotics (report, July 27), it would be well to consider whether they are necessary at all.

Antibiotic resistance has arisen due to indiscriminate use, often because it is easier to prescribe than explain that antimicrobials have no effect on the commonest infections, which are viral.

I cannot remember the number of times a patient has returned for a first post-operative visit to tell me that their GP has diagnosed a wound infection and prescribed antibiotics without taking samples to confirm the diagnosis – when all that was apparent was the normal post-surgical inflammatory response.

Doctors certainly need further educating on this subject, but so do the public.

David Nunn FRCS West Malling, Kent

SIR – I suspect that already a significant number of patients do not take the full course of their antibiotics.

My concern is with how the residual medications are dealt with. They should, of course, be returned to the dispenser for destruction. However, human nature being what it is, the easier option of disposal into the sewers or waste bin will be more appealing. What will this do to foster antibiotic resistance?

We should be seeking to clarify what the correct length of the course is – easier said than done. But advising patients to end their course early could make a bad situation worse.

Ceri Twiston Davies St Lawrence, Jersey

SIR – From my late teens until I moved to Canada aged 28, I suffered extremely painful cystitis flare-ups.

In Canada, this problem was cleared up for ever within two weeks. The GP told me to continue the antibiotic medicine for a week after my symptoms disappeared because the “bug” would likely remain without symptoms for a while. The reason for the past flare-ups was that, every time the cystitis had incompletely cleared up, the antibiotics had been stopped.

All those years of insufficient antibiotics meant unnecessary expense for the NHS – not to mention misery for me.

Josephine Evans Ampleforth, North Yorkshire