Antibiotics Are Prescribed for Too Long

Antibiotics to treat serious infections are being prescribed for too long, encouraging pathogen resistance, according to a new study.

Researchers at the Academic Medical Centre (Amsterdam, The Netherlands) compared the effectiveness of discontinuing treatment with the antibiotic amoxicillin after three days or eight days in adults admitted to a hospital with mild-to-moderate severe community-acquired pneumonia. A total of 119 patients who substantially improved after the conventional three days' treatment with intravenous amoxicillin were randomly assigned to either oral amoxicillin (63 patients) or a dummy pill (56 patients) three times daily for five days. The patients were assessed after seven, 10, 14 and 28 days.

In the three day and eight day treatment groups, the clinical success rate at day 10 was 93% for both, and after four weeks it was 90% compared with 88%. Both groups had similar resolution of symptoms, x-ray results, and length of hospital stay. The results were published in the June 10, 2006, issue of the British Medical Journal.

"In general, over-use of antibiotics is increasing bacteria's resistance to them. The important thing is to assess patients after three days and if their symptoms are improving and their temperature is below 38oC then they can come off the antibiotics,” said lead author Dr. Jan Prins, an infectious diseases consultant. "A shorter duration of treatment can also help to reduce overall antibiotic consumption and resistance rates for respiratory infections.”

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



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