Antibiotics are essential to treat serious infections caused by bacteria. Unfortunately, the more bacteria are exposed to antibiotics, the more likely they are to become resistant. This means that antibiotics stop working. So it is important that antibiotics are only used when they are needed.

Whilst antibiotics kill bacteria, they don’t cure viral infections. When sick patients arrive at hospital, doctors have to try to work out whether they have a bacterial infection, viral infection, or another illness altogether. This is difficult, because initially the symptoms can be very similar (e.g. cough, temperature).

Finding out exactly why a patient is sick takes a while, so it makes sense to give antibiotics initially. However, Department of Health guidance recommends stopping antibiotics when it becomes clear that they aren’t needed anymore. This could be because doctors work out that the patient never had a bacterial infection, or because they have got better. Stopping antibiotics when they aren’t needed reduces the chances of disease-causing and other gut bacteria becoming resistant to antibiotics. It is also important because antibiotics kill ‘friendly’ gut bacteria.

However, stopping antibiotics when they are no longer needed often doesn’t happen. Sometimes this is ‘just in case’ or thinking ‘better safe than sorry’, or because of the myth that antibiotic courses must be completed to avoid resistance. But, because gut bacteria, rather than those causing disease, become antibiotic-resistant during treatment, taking more antibiotics than really needed is not a safe strategy for the future.

There is no good evidence on how best to encourage doctors to stop giving unnecessary antibiotics in hospitals and changing behaviour is hard. The ARK-Hospital Programme is seeking to address this by developing a package of measures – the ‘Antibiotic Review Kit’ – to help healthcare staff stop antibiotics when they are no longer needed, and by testing this package to see if it reduces overall antibiotic use.

Find out more about the ARK website

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