How Long Should You Take an Antibiotic?
Tue, June 27, 2006 at 04:41AM For the last 40 years patients have been told to finish their antibiotic course (usually 5 days or more), even if they’ve obviously recovered. The idea has been to make sure that all bacteria are eliminated so that antibiotic-resistant strains won’t develop. (Of course, this logic is faulty; if there’s just one resistant bug, taking the antibiotic for longer won’t help.)
After all this time doctors in the Netherlands have now tested the success of a 3-day course of amoxicillin in patients with mild to moderate ‘community acquired’ pneumonia, compared with the normal 8-day course. The 3-day course was only used in those patients who had substantially improved. After 10 days the clinical success rate was 93% for both durations of treatment. The doctors claim that the shorter treatment is considerably cheaper, and it “may help control the growing resistance rates of respiratory pathogens”. This statement is more logical than the reasoning for 5 day+ medication. (Note that amoxycillin is not necessarily the treatment of choice for community acquired pneumonia in the USA.)
Longer antibiotic treatment now seems like taking a hammer to crack a walnut. We wonder how many other common clinical ‘rules of treatment’ should be reassessed from time-to-time, to see if we’ve been doing other things wrong all these years.
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