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Shortened courses of antibiotics for bacterial infections: A systematic review of randomized controlled trials.
Pharmacotherapy. 2018 Apr 20;:
Authors: Hanretty AM, Gallagher JC
Abstract
BACKGROUND: Commonly prescribed durations of therapy for many, if not most, bacterial infections are not evidence-based. Misunderstandings by clinicians and patients alike influence perspectives on antibiotic use, including duration of therapy and its role in antibiotic resistance.
OBJECTIVE: To demonstrate that shorter durations of antibiotic therapy are as efficacious as longer durations for many infections.
DATA SOURCES: A systematic review of English language articles using PubMed were identified for inclusion. Additionally, infection-specific guidelines were identified for review of recommendations. Search terms included specific infection types, randomized controlled trial (RCT), duration of therapy, treatment duration, short course, and long course.
STUDY SELECTION: Only RCTs of single-agent antibiotic therapy for the treatment of bacterial infections in adults were included.
DATA EXTRACTION: Independent data extraction of articles was conducted by two authors using predefined guidance for article inclusion.
DATA SYNTHESIS: In total, 23 RCTs met our criteria for inclusion. All trials compared single-agent antibiotics for a short and long antibiotic course in six common infections: community-acquired pneumonia, ventilator-associated pneumonia, intra-abdominal infections, skin and soft tissue infections, uncomplicated cystitis, and complicated cystitis or pyelonephritis.
CONCLUSIONS: Clinicians can decrease net antibiotic use by recommending shorter courses where evidence supports them. Antimicrobial stewardship programs that systematically address treatment duration may significantly impact institutional antibiotic use without negatively affecting patient care. This article is protected by copyright. All rights reserved.
PMID: 29679383 [PubMed - as supplied by publisher]