An antibiotic course of 5 days is usually just as effective as longer courses but with fewer side effects and decreased overall antibiotic exposure for a number of common bacterial conditions, according to new clinical guidelines published today by the American College of Physicians.
The guidelines focus on treatment of uncomplicated cases involving pneumonia, urinary tract infections, cellulitis, chronic obstructive pulmonary disease (COPD) exacerbations, and acute bronchitis. The goal of the guidelines is to continue improving antibiotic stewardship given the increasing threat of antibiotic resistance and the adverse effects of antibiotics.
"Any use of antibiotics (including necessary use) has downstream effects outside of treating infection," Dawn Nolt, MD, MPH, a professor of pediatric infection disease at Oregon Health & Science University in Portland, told Medscape Medical News. Nolt was not involved in developing these guidelines. "Undesirable outcomes include allergic reactions, diarrhea, and antibiotic-resistant bacteria. When we reduce unnecessary antibiotic, we reduce undesirable outcomes," she said.
According to background information in the paper, 1 in 10 patients receives an antibiotic prescription during visits, yet nearly a third of these (30%) are unnecessary and last too long, especially for sinusitis and bronchitis. Meanwhile, overuse of antibiotics, particularly broad-spectrum ones, leads to resistance and adverse effects in up to 20% of patients.
