Nearly nine in 10 Americans surveyed said they believe it’s important to always finish a prescribed antibiotic course.
About 60% preferred taking antibiotics for seven days or longer rather than a shorter three- to five-day course.
Researchers say patients should talk with their clinicians about the appropriate length of treatment rather than relying on the old “always finish your antibiotics” rule.
If you’ve ever been prescribed antibiotics, you’ve probably heard the same advice: Take the entire prescription, even if you start feeling better. It’s a message that has been repeated for years by doctors and public health campaigns.
But medical thinking about antibiotic treatment has evolved. Research has found that shorter courses can be just as effective — and sometimes safer — than longer ones for many common bacterial infections. That means the old idea that everyone should always complete a long course of antibiotics doesn’t apply to every situation.
A new study from researchers at the University of Utah and the University of Alabama at Birmingham looked at how well Americans understand those changing recommendations. The findings suggest that the older message remains deeply ingrained.
“Historically, there was very strong guidance by major health organizations and clinicians that you must always finish the course,” researcher Alistair Thorpe, PhD, said in a news release.
“Now, we’re seeing a growing body of evidence saying that that is not always the case. And oftentimes, shorter durations of antibiotics are as effective and safe as longer alternatives.”
How the study worked
Researchers surveyed 1,475 U.S. adults online between March and April 2024. Participants were at least 18 years old and were recruited through Dynata, which compensated them for taking part.
The survey asked participants which antibiotic treatment they would feel more comfortable taking for a bacterial respiratory infection, such as pneumonia: a shorter course of three to five days or a longer course of at least seven days.
Participants also answered questions about whether they had been told to always finish their antibiotics, whether they had been told they could stop taking them when they felt better, and how they viewed the safety and effectiveness of different treatment lengths.
Most people still favor longer courses
The majority of respondents — 60.4% — said they would prefer a course lasting at least seven days, compared with 39.5% who preferred three to five days. More than 60% also viewed longer courses as safer and more effective.
Meanwhile, 88.4% agreed that it’s important to always finish a prescribed antibiotic, even after they begin feeling better. About three-quarters of respondents who had received that advice said it came from a medical professional.
The researchers say these beliefs may be partly explained by how often Americans have heard the traditional message. But they emphasize that antibiotic recommendations can change as researchers learn more.
For consumers, the takeaway isn’t to stop an antibiotic early on their own. Instead, the researchers recommend having a conversation with your clinician about the appropriate treatment length for your particular infection and when you should stop taking the medication.
“Evidence is growing and guidance is evolving on antibiotic use, which is a normal process and a good sign that we are working to improve how we provide care,” Dr. Thorpe said.
“Our knowledge about how best to use antibiotics has changed, but it has changed because we’re learning more, and it’s important that we make sure we are communicating this well to the public.”