The following is a summary of the “Short-course antibiotics for common infections: what do we know and where do we go from here?,” published in the February 2023 issue of Clinical Microbiology and Infections Disease by Lee et al.

More than 120 randomized controlled studies (RCTs) conducted over the past 25 years show that short courses of antibiotics are equivalent to long durations in treating common bacterial illnesses. The purpose of this study was to investigate whether or not clinical data from RCTs confirm the mantra shorter is better’ for antibiotic durations in 7 common diseases (pneumonia, UTI, IAI, bacteremia, SSTI, BTI, SSTI, BNI, pharyngitis, sinusitis).

Searches of PubMed and clinical guideline papers turned up published RCTs comparing short and extended courses of antibiotics. When the diagnosis is made, the right antibiotic is used, and the patient shows signs of improvement, short courses of antibiotics have been shown to have the same success rates as longer antibiotic courses in the treatment of community-acquired pneumonia, complicated urinary tract infections in women, gram-negative bacteremia, and skin and soft tissue infections. 

In the absence of implanted foreign substances and surgical debridement, a course of antibiotics lasting six weeks is sufficient for treating osteomyelitis in patients. While preliminary research shows promise, it is still being determined if debridement can further reduce recovery times. In most cases, shorter courses of treatment were as effective as longer ones, suggesting that future studies should focus on better characterizing the target group, determining the optimal combination of antimicrobials, and generating actionable data for frontline physicians.

Source: sciencedirect.com/science/article/abs/pii/S1198743X2200461X