Victorian Infectious Diseases Service, The Royal Melbourne Hospital.
Peter Doherty Institute for Infection and Immunity, University of Melbourne.
Curr Opin Infect Dis. 2020 Dec;33(6):433-440. doi: 10.1097/QCO.0000000000000680.
Although there is increasing recognition of the link between antibiotic overuse and antimicrobial resistance, clinician prescribing is often unnecessarily long and motivated by fear of clinical relapse. High-quality evidence supporting shorter treatment durations is needed to give clinicians confidence to change prescribing habits. Here we summarize recent randomized controlled trials investigating antibiotic short courses for common infections in adult patients.
Randomized trials in the last five years have demonstrated noninferiority of short-course therapy for a range of conditions including community acquired pneumonia, intraabdominal sepsis, gram-negative bacteraemia and vertebral osteomyelitis.
Treatment durations for many common infections have been based on expert opinion rather than randomized trials. There is now evidence to support shorter courses of antibiotic therapy for many conditions.
尽管越来越多的人认识到抗生素过度使用与抗菌药物耐药性之间的联系，但临床医生的处方往往过长，并且受到临床复发的恐惧的驱动。需要高质量的证据来支持更短的治疗持续时间，以使临床医生有信心改变处方习惯。在这里，我们总结了最近的随机对照试验，这些试验研究了成人常见感染的抗生素短疗程治疗。
在过去五年中，随机试验已经证明了短程治疗一系列疾病的非劣效性，包括社区获得性肺炎、腹腔内脓毒症、革兰氏阴性菌血症和脊椎骨髓炎。
许多常见感染的治疗持续时间是基于专家意见而不是随机试验。现在有证据支持许多疾病的抗生素治疗疗程更短。
