In what will surely evoke tremendous controversy throughout the clinical world, this BMJ paper argues that telling patients to stop taking antibiotics when they feel better is usually preferable to having them finish the entire treatment course, and that this new policy would be expected to lessen antibiotic resistance.
Both patients and medical students have traditionally been told that one must complete courses of antibiotics, as taking too short a course of threatment will allow the offending bacteria to mutate and become drug resistant. The authors of this paper challenge this time-honored orthodoxy, writing that “for common bacterial infections no evidence exists that stopping antibiotic treatment early increases a patient’s risk of resistant infection” and that “patients are put at unnecessary risk from antibiotic resistance when treatment is given for longer than necessary, not when it is stopped early.”
Want to explore the controversy in some detail? After reading the Open Access article itself , follow up with the numerous insightful “rapid responses” comments . One interesting point made in the commentary section concerns the unexpected finding that bacteria at the bottom of a 1,000 foot cave in New Mexico “although isolated from humans and antibiotic drugs for four million years, are resistant to 14 different commercially available antibiotics” .
 Bhullar K, Waglechner N, Pawlowski A, Koteva K, Banks ED, Johnston MD, Barton HA, Wright GD. Antibiotic resistance is prevalent in an isolated cave microbiome. PLoS One. 2012;7(4):e34953. doi: 10.1371/ journal.pone.0034953. Epub 2012 Apr 11. PubMed PMID: 22509370; PubMed Central PMCID: PMC3324550.