ACP recommends shortening the antibiotic treatment time for common bacterial infections

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Overuse of antibiotics, especially broad-spectrum antibiotics, can lead to drug resistance and related adverse events in up to 20% of patients.

Cases of overuse of antibacterial drugs include unnecessary prolonged antibiotic treatment for patients with common bacterial infections.

Clinicians play an important role in the management of antibacterial drugs, and quality improvement strategies can improve the prescription of antibacterial drugs.

The appropriate application of antibiotics is defined as the prescription of an appropriate dose of antibiotics in an appropriate time for a specific situation.

When clinically safe and supported by evidence, shortening the treatment time of antibiotics can reduce the overall amount of antibiotics, thereby reducing the risk of adverse reactions in patients due to antibiotics.

Recently, the American College of Physicians (ACP) has put forward best practice recommendations for the proper use of antibiotics in several common bacterial infections.
Let’s take a look! Simple acute bronchitis and acute exacerbation of COPD ➤For patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) and acute simple bronchitis with bacterial infection and clinical symptoms (dyspnea, purulent sputum and/or increased sputum volume), The time limit for antibiotic treatment is 5 days.

Community-acquired pneumonia (CAP) ➤For CAP patients with normal immune function, antibiotic treatment should be prescribed for at least 5 days.
After antibiotic treatment is applied for 5 days, prolonged antibiotic treatment should be based on "proven clinical stability indicators", including vital signs and eating ability And mental state.

Urinary tract infection ➤For female patients with simple bacterial cystitis, use a short course of antibiotic treatment: nitrofurantoin for 5 days, trimethoprim-sulfamethoxazole (TMP-SMZ) for 3 days, or fosfomycin as a single dose medicine.

➤For men and women with simple pyelonephritis, fluoroquinolones are used for 5-7 days or TMP-SMZ for 14 days based on antibiotic sensitivity.

Cellulitis ➤For patients with non-suppurative cellulitis, especially those who can conduct self-monitoring and maintain close contact with primary doctors, a 5-6 day antibiotic treatment plan can be prescribed.

Precautions ➤Immune function, pregnant women, patients with complicated infections due to other reasons or recent history of drug-resistant bacteria infections are not applicable to the above recommendations.

➤The recommendation does not provide guidance on the best antibiotics for every infection.

If the patient does not improve after treatment, the clinician should evaluate the patient's other causes.

➤When treating common clinical infections such as bronchitis, pneumonia, urinary tract infections and skin infections, clinicians should be aware that compared with long-term antibiotics, short-course antibiotics can achieve the same or even better results, and can also reduce Antibiotic resistance.

References: 1.
Rachael A, Robert M.
et al.
Appropriate Use of Short-Course Antibiotics in Common Infections: Best Practice Advice From the American College of Physicians.
Ann Intern Med.
2021 Apr 6.
doi: 10.
7326/M20-7355.
2 .
Summary for Patients: Appropriate Use of Short-Course Antibiotics in Common Infections: Best Practice Advice From the American College of Physicians.
Ann Intern Med.
2021 Apr 6.
doi: 10.
7326/P21-0003.
3.
ACP recommends shorter antibiotic courses for common bacterial infections.
By Janel Miller.
April 05, 2021.