My husband has this bad habit. When antibiotics were prescribed for a week or two, he rarely completed the entire course of treatment. Once his symptoms subsided, he threw away the remaining pills, despite the warning on the bottle that he would complete the prescription. Ignoring the doctor’s order is not a good idea, but in this case, he might make a difference.
Dozens of studies have shown that for many bacterial infections, a short-term course of antibiotics on a daily basis is as effective as a traditional course of treatment on a weekly basis. A shorter course also has a lower risk of side effects. In April, the power of this research persuaded the American College of Physicians to issue a new “Best practice recommendations“Applies to four types of infections: pneumonia (the kind obtained in the community rather than in the hospital), “uncomplicated” urinary tract infection (UTI), a skin infection called cellulitis (if there is no pus), and People with acute bronchitis have chronic obstructive pulmonary disease. “These are some of the most common infections that physicians treat every week, and there are many unnecessary treatments,” the first author of the advice statement, an infectious disease specialist at the University of Alabama at Birmingham Rachael Lee said. A big question in the future is: Will the medical profession respond to the call and change its approach?
The driving force behind the more cautious use of antibiotics is the global threat of drug-resistant microorganisms, which have developed rapidly with the overuse of these drugs.Dangerous organisms include the terrifying “carnivorous” MRSA (methicillin-resistant Staphylococcus aureus), and drug-resistant microbial strains that cause urinary tract infections, tuberculosis, and malaria. However, many doctors mistakenly believe that a longer course of antibiotics can prevent resistant strains. Brad Spelberg, chief medical officer of Los Angeles County/USC Medical Center and an infectious disease expert, said: “Imagine it as an urban legend with no substance.” Spelberg said that doctors used to Antibiotics will be prescribed while the infection is controlled and the patient is out of danger. “But the duration is getting longer and longer because of the false belief that’if I treat longer, I will prevent recurrence caused by drug-resistant pathogens’-this is absolutely wrong.”
Spelberg is an active advocate of the “shorter is better” approach. His website (bradspellberg.com/shorter-is-better) Follow up randomized controlled trials that show the comparison of short courses of antibiotics with longer courses. This spring, the website listed more than 70 studies on 14 infectious diseases. These studies show that short-term treatments can also do the job well, although in some trials, short-term antibiotics are different from long-term drugs. Some of these studies have also linked shorter use to reducing the emergence of resistant microorganisms. Spelberg likes to point out that the rule of one or two weeks is inherently absurd. He called it the “Unit of Constantine” and applied to the Roman emperor who ordered a week to be 7 days in 321 AD. He observed that this indicator has no biological meaning.
The evidence supporting short courses is particularly applicable to community-acquired pneumonia.At least 12 adult randomized controlled trials have shown that taking 3 to 5 days of antibiotics is as effective as taking 5 to 14 days of antibiotics, and Study in 2021 It was found that the same applies to children. More than 25 studies have shown that short courses are also suitable for acute attacks of sinus infections and chronic bronchitis. Spelberg pointed out that these two conditions may be caused by viruses, in which case antibiotics will not help at all. “If you plan to use antibiotics for people who don’t need them, at least ask us to use them politely for a while,” he said.
There are other advantages to a shorter course of medication. They may cause less harm to the beneficial bacteria belonging to our microbiome (one of the reasons why fewer pills leads to fewer side effects). Short prescriptions can lead to better patient compliance. “It’s easier to remember to take medicine for 5 days than to take it for 10 days,” said Helen Boucher, director of infectious diseases at Tufts Medical Center and treasurer of the Infectious Disease Society of America (IDSA). But investigations show that the old prescription drug habits are difficult to change.A sort of Antibiotic Prescription Research in 2019 Among 10,616 family doctors in Ontario, it was found that 35% of the scripts were 9 days or longer.
Some infections do require long-term treatment.A study Published in May It was found that six weeks of antibiotics were not as effective as 12 weeks for the treatment of infections around the prosthetic joints. Although antibiotics are often overused to treat ear infections in children, longer courses are more effective for children under two years of age.
Boucher said: “A prescription for antibiotics of the right size is a key part of the fight against drug-resistant “superbugs”. “This is the message that IDSA has been working hard to drive home for many years. “As patients, we can also do our part. Ask your doctor about the shorter duration and whether the pill really has the potential to accelerate your recovery.