Several common bacterial infections can be effectively treated with shorter courses of antibiotics than traditionally prescribed, according to new guidance released April 6 by the American College of Physicians.
The treatment focuses on bronchitis, pneumonia, urinary tract infections and skin infections (cellulitis).
“Physicians and patients need to be aware that using antibiotics for shorter periods can have the same – and often better – results compared to longer periods and may also help lower antibiotic resistance,” wrote Amir Qaseem, MD, Ph.D. .D., Director of Clinical Policy at ACP, and colleagues.
The recommendations describe short-term appropriate best practice practices for the following conditions and in these circumstances:
- Treatment with antibiotics in patients with uncomplicated pneumonia should be at least five days. The patient’s clinical symptoms should lead to decisions for longer than five days of treatment.
- When treating uncomplicated bladder infection in women, limit treatment to five days nitrofurantoin, three days trimethoprim – sulfamethoxazole (TMP – SMX), or one dose of phosphomycin.
- Treatment of uncomplicated kidney infection should be limited to five to seven days of fluoroquinolone rather than 14 days of TMP-SMX. Laboratory tests should guide the choice of antibiotic types.
- Uncomplicated treatment of skin infection should be limited to five to six days of an antibiotic that covers streptococci, a common cause of these infections.
Using antibiotics unnecessarily or for longer periods than necessary can expose patients to medical side effects without benefit and may contribute to antibiotic resistance, the authors said.
The new guidance may not apply to people with immune compromise, people with complicated infections due to other causes, complicated anatomy, or a recent history of resistant bacterial infections, among other considerations, they advised.
The guidance appears in the Annals of Internal Medicine,