to ignore doctors advice on antibiotics

[Chala86]

After dealing with a really stubborn bout of cystitis over Christmas and struggling to actually get an appointment at the doctors I finally managed to get myself to their out of hours walk in clinic yesterday and was prescribed antibiotics. The doctor said he would prescribe a 7 day course of 2 a day. Fair enough and as expected. Then he said 'you may feel better after three days, in which case you can stop taking them .' Am AIBU in thinking I should ignore this, regardless of whether I feel better , and just take the full 7 day course? I always thought taking half a course was asking for trouble but please correct me if I'm wrong.

Depends on which antibiotic. Trimetheprim, which is commonly used to uni's, is only a 3 day course but I got a box of 14 which is enough for 7 days.

It is cheaper to provide whole box that split them apparently. The other 8 tablets would go to waste. Extending the course to 5 or 7 days if UTI not fully resolved after 3 is pragmatic use of resources IMO.

They are nitrofurantain. Just wanted for it to be gone and not come back worse because I've only taken three days worth. But if doctors advice is within guidelines I'll do as recommended.

Isn't that what causes antibiotic resistance - people not taking the full amount and then the bacteria developing immunity because they have not been properly destroyed ?

3 days of antibiotics for a UTI is very, very, very standard and is a 'full' course. 3 days in a woman really should do the job.

www.nice.org.uk/advice/ktt10/chapter/evidence-context

There's actually a growing body of evidence that we don't need to take what was thought of as the 'full' course of antibiotics once patients are asymptomatic, which is being researched more properly and may change clinical practice in the future.

I'd take 3.5 days and save the other pills for the next bout of cystitis. Note I am not a GP, but have had a lot of bad cystitis!

I think it's unusual for doctors' to say don't finish the course. If it was me I would finish the course.

I had similar last month and was prescribed a 3 day course but told to return for more if it hadn't cleared. Perhaps your doc knew how difficult it was to get an appointment at the moment and prescribed extra rather than require you to come back in.)

The full course is 3 days for uncomplicated cystitis in a non pregnant woman. The OP has been told to complete the course.

The widely available packs have 14 tablets in them and it is apparently not cost effective to split them since the rest of the tablets will be wasted.

Taking 7 days worth of ABx is extending the course. Which is reasonable if there are residual symptoms after 3 days treatment. Even if the initial symptoms are in keeping with cystitis there may be some involvement of the upper renal tract which needs a longer course to clear. This may not have been apparent at presentation if the pain on urinating or bladder irritation predominated.

The doctor's advice is not unusual or wrong. It is in keeping with well recognised guidelines and the therefore good medical practice.

When people say to complete the course they mean complete the course prescribed for you by your doctor. I'm sure the doctor knows best!

Why would anyone want to take more antibiotic than they needed or their doctor recommended? Agree 3 days for uncomplicated cystitis is normal. More just wipes out your normal gut bacteria so harmful ones can live there and travel to your bladder and cause more infections.

Depends on the antibiotics but for usual 1st/2nd line antibiotics the standard course for uncomplicated UTI in women is 3 days, but can be extended to a longer course of 7 days duration if needed.

If I were you I'd follow the advice given by your doctor. Alternatively, get a second opinion if you are not happy with the advice given by the first Dr. Don't make it up by yourself.

The OP is dealing with a 'stubborn' bout of cystitis and been prescribed 5 days supply. If it was me I would take the 5 days supply (not 3) - to be sure.

Beangirls "I'm sure the doctor knows best" - they don't always. Doctors are just people and if no blood test has been done they are operating partly on a "best guess" - an awful lot of medicine is informed (hopefully... usually fairly well informed...) guess work, and doctors get it wrong fairly frequently.

There is absolutely nothing at all wrong with questioning a doctor's advice. Sometimes the wrong advice makes things worse. In fact it is the responsible thing to do if you feel uneasy. That doesn't mean just make your own different treatment plan up, but it is the intelligent, sensible, switched on thing to do to question if something doesn't sound right. If the majority on here had agreed it sounded wrong the OP would have been well advised to seek a second medical opinion - talk to a pharmacist or see another GP.

I would take the 7 day course to be 100 % sure its gone. Having the extra 4 wont hurt you one bit.
And for what its worth, if you do decide to only take three then you can take the remaining 4 at another stage if it comes back. You know your own body.
Another poster said that is a no no, but if you have been originally prescribed them its not a problem.

OP just been reading through the whole thread.
Just take the whole 5/7 day course and you will be fine. At least you would have given it a blasting. I dont know why you are questioning it. They are only antibios. Hope you feel better soon

Likewise it is important to return to your GP if, after a course of treatment (be it 3,5 or 7 days), you still have symptoms of uti. I was seen at walk in centre with 3 day history of loin pain, increased frequency, and uti symptoms not relieved by cystitis over the counter treatments; was given a pot for a sample, which was dipped and +ve for uti but 3 days back/loin pain was ignored by the nurse (as proved by the report sent to go which didn't mention pain at all). I was given 3 days antibiotics (nitrofurantoin) and told to go to go if not improved.
On 4th day went to go as felt much worse and, after discussing sumptoms and treatment so fat, was changed onto a different drug for 10 days and told that, because of the loin pain, it should have been picked up on as being more than a simple uti and treated as nephritis.

Took me about 3 weeks to feel well again!!

Remember - that sounds pretty unpleasant. Will make sure I go back if symptoms do carry on. Feeling much better today, although on and off it does seem to be hanging about.
I've only been on antibiotics once before this for impacted wisdom tooth infection and tend to avoid them if I can. I'll see how I feel tomorrow (day 4). If symptoms are still about will keep taking them - even if they do make me feel slightly sick. But feels like its pretty much gone now .

Another poster said that is a no no, but if you have been originally prescribed them its not a problem.

It's still a problem if the health issue is not the same, although it may look the same to the person.
Recurrent bouts of cystitis should definitely be further investigated, not just throw the same short course of antibiotics at them.