Antibiotic treatment of common infections: more evidence to support shorter durations

Curr Opin Infect Dis. 2020 Dec;33(6):433-440. doi: 10.1097/QCO.0000000000000680.

Abstract

Purpose of review: Although there is increasing recognition of the link between antibiotic overuse and antimicrobial resistance, clinician prescribing is often unnecessarily long and motivated by fear of clinical relapse. High-quality evidence supporting shorter treatment durations is needed to give clinicians confidence to change prescribing habits. Here we summarize recent randomized controlled trials investigating antibiotic short courses for common infections in adult patients.

Recent findings: Randomized trials in the last five years have demonstrated noninferiority of short-course therapy for a range of conditions including community acquired pneumonia, intraabdominal sepsis, gram-negative bacteraemia and vertebral osteomyelitis.

Summary: Treatment durations for many common infections have been based on expert opinion rather than randomized trials. There is now evidence to support shorter courses of antibiotic therapy for many conditions.

Publication types

  • Systematic Review

MeSH terms

  • Adult
  • Anti-Bacterial Agents / administration & dosage*
  • Antimicrobial Stewardship / methods
  • Bacteremia / drug therapy
  • Bacterial Infections / drug therapy*
  • Community-Acquired Infections / drug therapy
  • Drug Administration Schedule
  • Duration of Therapy
  • Female
  • Gram-Negative Bacterial Infections / drug therapy
  • Humans
  • Male
  • Osteomyelitis / drug therapy
  • Pneumonia / drug therapy
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians'
  • Randomized Controlled Trials as Topic
  • Sepsis / drug therapy
  • Time Factors
  • Urinary Tract Infections / drug therapy

Substances

  • Anti-Bacterial Agents