Analysis

The antibiotic course has had its day

BMJ 2017; 358 doi: https://doi.org/10.1136/bmj.j3418 (Published 26 July 2017) Cite this as: BMJ 2017;358:j3418

Sober statements in the article, but an attention grabbing, misleading headline

Martin Llewelyn and colleagues argue that "with little evidence that failing to complete a prescribed antibiotic course contributes to antibiotic resistance, it’s time for policy makers, educators, and doctors to drop this message." What surprises everyone is that this sober statement followed, tabloid style an attention grabbing, misleading headline, which asserted that "The antibiotic course has had its day".

Maybe the BMJ editorial team chose this title and the authors blindly endorsed the choice. Most of the rapid responses were critical of the tone and content of the article. One of the readers called it an opinion piece.

DR ABDUL GHAFUR, Consultant in Infectious diseases, Apollo Cancer Institute, Chennai, India in his rapid response, has been very blunt in voicing his concern, thus: "It is true that controversial articles create widespread discussion on important issues. Unfortunately, this article has probably done more harm than good to the field of antibiotic stewardship. This article is based on concrete facts, but written in a highly misleading way and interpreted by media and the public in a dangerously erroneous style."

While many news outlets reproduced the telling title of the paper written by 10 senior researchers, very few of them made critical analysis of the issues. The Hindu, which publishes a very popular Science and Technology section is an exception. It bemoaned the fact that the media’s coverage of the article too was unquestioning. It referred to an article in The Guardian, titled “Rule that patients must finish antibiotics course is wrong, study says" with a subtitle “Experts suggest patients should stop taking the drugs when they feel better rather than completing their prescription”. The Hindu article noted that it was shared 25,000 times.

A telling blog titled "Why BMJ’s advice to ‘stop taking antibiotics when you feel better’ should be ignored" by Dr. R. Prasad, the Science Editor, The Hindu, is unambiguous and clear.

He found out how widely the wrong message had spread by reviewing the Altmetric score of the BMJ paper on August 14, 2017

"With an Altmetric score of 3,244, it falls in the top 5% of all research outputs scored by Altmetric. From The BMJ, it is the second highest scoring paper. The number of newspapers that have covered this paper stands at 187; the actual number would be much higher as not all newspapers get counted by Altimetry", Dr. Prasad clarified.

"There have been nearly 3,000 tweets and 92 Face book pages about this paper. It has been shared the most in the UK with a score of 300, closely followed by the U.S. with 271." he added

Considering the unguided and unmonitored influence of social media, impartial observers may wonder whether it is better to conduct such controversial discussions on antibiotics, etc, in seminar halls or scholarly academies to arrive at appropriate guidelines before medical journals publish them!

Competing interests: No competing interests

15 August 2017
Dr. K S Parthasarathy
Ritired Scientific Officer
Atomic Energy Regulatory Board
Navi Mumbai 400706