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Medicineworld.org: Are Antibiotics Being Used For Too Long?

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Are Antibiotics Being Used For Too Long?

Are Antibiotics Being Used For Too Long?
Taking antibiotics for three days is just as effective for community acquired pneumonia as continuing therapy for the recommended 7-10 days, finds a study in this week's BMJ. Shorter therapy can also help contain growing resistance rates.

The study raises questions about the optimal duration of antibiotic treatment for common infections.

Community acquired pneumonia is one of the most important indications for antibiotic prescriptions in hospitals. But a lack of evidence to support short course treatment means it has become accepted practice to continue therapy for days after symptoms have improved.

Scientists in the Netherlands compared the effectiveness of discontinuing therapy with amoxicillin after three days or eight days in adults admitted to hospital with mild to moderate-severe community acquired pneumonia.

119 patients who substantially improved after the conventional three days' therapy with intravenous amoxicillin were randomly assigned to oral amoxicillin (63 patients) or placebo (56 patients) three times daily for five days. Patients were assessed at days 7, 10 (two days after therapy ended), 14, and 28.

In the three day and eight day therapy groups, the clinical success rate at day 10 was 93% for both, and at day 28 was 90% compared with 88%. Both groups had similar resolution of symptoms, x-ray results, and length of hospital stay.

These findings show that discontinuing amoxicillin therapy after three days is not inferior to discontinuing it after eight days in adults with mild to moderate-severe community acquired pneumonia who have substantially improved after an initial three days' therapy, say the authors.

A shorter duration of therapy can also help to reduce overall antibiotic consumption and resistance rates for respiratory infections, they conclude.

This study suggests that current guidelines recommending 7-10 days should be revised, says Dr John Paul from the Royal Sussex County Hospital, in an accompanying commentary.

Not only does the study yield good evidence in favour of short course treatment for a subset of patients with community acquired pneumonia, but also shows how centres can cooperate to tackle longstanding areas of uncertainty in clinical microbiology and infectious diseases, he writes. A number of other common clinical situations would repay the efforts of comparable approaches.



Posted by: Mark    Source




Did you know?
Taking antibiotics for three days is just as effective for community acquired pneumonia as continuing therapy for the recommended 7-10 days, finds a study in this week's BMJ. Shorter therapy can also help contain growing resistance rates. The study raises questions about the optimal duration of antibiotic treatment for common infections.

Medicineworld.org: Are Antibiotics Being Used For Too Long?

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