Antibiotics can be taken in shorter periods
TUESDAY, April 6, 2021 (HealthDay News) – Millions of Americans have come a long way at some point in their lives antibiotics a to treat bacterial infection. But according to new recommendations from a major group of U.S. doctors, some of the most common bacterial infections can be treated with shorter courses of medication.
The advice, from the American College of Physicians (ACP), says that shorter courses of antibiotics in various types of infections work, and they also do so with greater safety.
In general, the ACP says they can be managed with antibiotics for five to seven days, or even three times in some cases, instead of the usual 10 days or more.
Many patients are accustomed to long courses, but their use was largely based on “conventional wisdom,” said ACP President Jacqueline Fincher.
In recent years, he said: clinical trials they have shown that they are just as effective as shorter courses in “eliminating” many infections.
Fincher also has a safer approach: shorter courses reduce the chance of side effects nausea and diarrhea. They can also help fight the broad problem antibiotic resistance – bacteria under the influence of an antibiotic mutate in an attempt to frustrate the drug.
Fincher said antibiotics, especially long-term ones, can kill the “good” bacteria that normally live in the body and keep different systems functioning properly.
Yeast infectionsHe pointed out that this balance is an example of what can be disturbed: when women take an antibiotic to get a GTI, this can reduce the good bacteria that keep yeast growth under control.
Fincher said a concern is deadly antibiotic-resistant intestinal infections It’s hard bacteria. These infections often arise after a person has been treated with antibiotics that have destroyed many good bacteria in the gut.
The new ACP recommendations recommend shorter courses of antibiotics for four infection groups:
- Acute bronchitis in people with chronic obstructive pulmonary disease. BPKA is the term for two serious lung diseases: emphysema and chronic bronchitis. When BPKE patients worsen their symptoms (acute bronchitis) and the cause may be a bacterial infection, ACP recommends antibiotic treatment for up to five days. (In previous advice, the ACP said that people without BPK do not need antibiotics to have acute bronchitis, at least when they may have pneumonia).
- Pneumonia. When people develop uncomplicated pneumonia, antibiotics should be given for at least five days, and perhaps longer depending on the symptoms.
- UTIs. Treatment can often be five to seven days, or even shorter. Women may be able to take a three-day antibiotic combination of trimethoprim-sulfamethoxazole for three days or a newer antibiotic called phosphomycin.
- Cellulite. It is a common skin infection and often affects the limbs. As long as the infection does not cause pus (such as an abscess), it can be treated with antibiotics for five to six days.
Fincher said the advice was based on these four groups, in part because they are so common. But shorter courses might be appropriate for other, less serious infections, he added.
Some conditions will require longer courses, Fincher said – including “deep” infections like osteomyelitis, where there is inflammation of the bone. Longer treatment may be better for some patients, such as those at risk for diabetes or the immune system, he said.
“Antibiotics can be life-saving, but like any medication, they have side effects,” said Dr. Helen Boucher, a board member of the American Association of Infectious Diseases.
First, it’s important to make sure patients need an antibiotic, said Boucher, who also heads the infectious disease division at Boston’s Tufts Medical Center.
He pointed out that 30% of antibiotic prescriptions in the United States are useless.
“Ask the doctor,‘ Do I really need this? ’Boucher advised. The next question, he said, could be long-term: If the prescription is 10 days long – “default” for many doctors, the ACP says – patients may be asked again why.
Why are shorter courses advocated now? Only in recent years have clinical trials begun to test for shorter and longer antibiotic treatment, Boucher explained. (Drug companies don’t have much incentive to consider fewer treatments, he noted.)
It was a problem of antibiotic resistance that Boucher said could be seen by researchers as effective as short courses.
The recommendations were published on April 6 in the journal ACP Annals of Internal Medicine.
The U.S. Centers for Disease Control and Prevention has more to offer antibiotic resistance.
SOURCES: Jacqueline Fincher, MD, president, Philadelphia College of American Physicians; Helen Boucher, MD, head of the division of geographic medicine and infectious diseases, Tufts Medical Center, Boston, and member, Board of Directors, Infectious Diseases Society of America, Arlington, Va .; Annals of Internal Medicine, April 6, 2021, online