Abstract:
BACKGROUND:It is well known that antibiotic use is the main driver for the increasing problems with resistant bacteria. Consequently, some countries have recommended shortening the duration of antibiotic treatment of community-acquired pneumonia (CAP). The aim of this study was to investigate whether the effectiveness of a short-course antibiotic is comparable to a longer course of antibiotics in adults with CAP and to assess whether the duration of an antibiotic course influences the development of resistant bacteria. METHODS:A literature search was performed in PubMed and EMBASE. We included randomized, controlled trials (RCTs) comparing clinical success, microbiological efficacy, patient safety and antibiotic resistance in a short-course (5 days) vs a long-course antibiotic treatment (7+ days) for CAP. RESULTS:Six RCTs were included. Clinical success rates were 87%-95% in patients treated with short-course antibiotics and 88%-94% in patients treated with a longer course. Eradication of pathogenic bacteria was found to be 100% and 95%-100% in patients treated with short-course and long-course antibiotics, respectively. No significant differences in adverse events were reported. However, none of the trials reported on the impact on the development of resistant bacteria. CONCLUSION:Only few trials were included in this review and more RCTs are highly needed to be able to provide solid evidence for optimal treatment durations for patients diagnosed with CAP. Importantly, fluoroquinolones were often the drug of choice, and trials testing beta-lactam antibiotics, which are the type of antibiotics most often used in many European countries, should be aimed for in near future.
journal_name
Basic Clin Pharmacol Toxicoljournal_title
Basic & clinical pharmacology & toxicologyauthors
Møller Gundersen K,Nygaard Jensen J,Bjerrum L,Hansen MPdoi
10.1111/bcpt.13205subject
Has Abstractpub_date
2019-05-01 00:00:00pages
550-559issue
5eissn
1742-7835issn
1742-7843journal_volume
124pub_type
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