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Short-course vs long-course antibiotic treatment for community-acquired pneumonia: A literature review

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@article{a5cf9429cce948a2b0b1d47f0e0d31a1,
title = "Short-course vs long-course antibiotic treatment for community-acquired pneumonia: A literature review",
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.",
keywords = "Anti-Bacterial Agents/administration & dosage, Community-Acquired Infections/drug therapy, Drug Administration Schedule, Fluoroquinolones, Humans, Patient Safety, Pneumonia/drug therapy, Randomized Controlled Trials as Topic",
author = "{M{\o}ller Gundersen}, Kamilla and {Nygaard Jensen}, Jette and Lars Bjerrum and Hansen, {Malene Plejdrup}",
note = "{\textcopyright} 2019 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).",
year = "2019",
month = may,
doi = "10.1111/bcpt.13205",
language = "English",
volume = "124",
pages = "550--559",
journal = "Basic & Clinical Pharmacology & Toxicology Online",
issn = "1742-7843",
publisher = "Wiley-Blackwell Publishing Ltd",
number = "5",

}

RIS

TY - JOUR

T1 - Short-course vs long-course antibiotic treatment for community-acquired pneumonia

T2 - A literature review

AU - Møller Gundersen, Kamilla

AU - Nygaard Jensen, Jette

AU - Bjerrum, Lars

AU - Hansen, Malene Plejdrup

N1 - © 2019 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).

PY - 2019/5

Y1 - 2019/5

N2 - 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.

AB - 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.

KW - Anti-Bacterial Agents/administration & dosage

KW - Community-Acquired Infections/drug therapy

KW - Drug Administration Schedule

KW - Fluoroquinolones

KW - Humans

KW - Patient Safety

KW - Pneumonia/drug therapy

KW - Randomized Controlled Trials as Topic

U2 - 10.1111/bcpt.13205

DO - 10.1111/bcpt.13205

M3 - Review

C2 - 30694600

VL - 124

SP - 550

EP - 559

JO - Basic & Clinical Pharmacology & Toxicology Online

JF - Basic & Clinical Pharmacology & Toxicology Online

SN - 1742-7843

IS - 5

ER -

ID: 59154883