November 01, 2021

Shorter antibiotic treatments for certain infections

It would be difficult to overstate the benefits of antibiotics in treating bacterial infections, preventing the spread of disease, improving health and saving lives.

But sometimes, you can have too much of a good thing: Overusing antibiotics not only promotes antibiotic resistance — when an antibiotic no longer works as well to kill or slow down bacteria growth — but also can lead to unnecessary side effects.

With this in mind, a recent review by the American College of Physicians (ACP) examined antibiotic treatment for several common infections. In reviewing data comparing longer and shorter courses of treatments, researchers found cases where shorter courses were just as good as longer courses.

Their conclusions, published in Annals of Internal Medicine, generally advised the following for uncomplicated infections:

  • Treat people with chronic obstructive pulmonary disease (COPD) who have developed presumed bacterial bronchitis with antibiotics for only five days.
  • Treat most bacterial pneumonia with antibiotics for five days. Longer treatment courses can be considered depending on the infection and clinical improvement.
  • Usually treat women who have bladder infections with nitrofurantoin (Furadantin, Macrodantin) for five days, sulfamethoxazole-trimethoprim (Bactrim) for three days, or just one dose of fosfomycin (Monurol).
  • Usually treat people who have kidney infections (pyelonephritis) with fluoroquinolone antibiotics for 5 to 7 days or with sulfamethoxazole-trimethoprim for 14 days.
  • Rarely treating cellulitis, a common bacterial skin infection, with antibiotics for more than 5 to 6 days.

There are circumstances where a longer...