Optimising antibiotic exposure by customising the duration of treatment for respiratory tract infections based on patient needs in primary care

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  • Carl Llor
  • Niels Frimodt-Møller
  • Marc Miravitlles
  • Gunnar Kahlmeter
  • Bjerrum, Lars

Primary care antimicrobial stewardship programs have limited success in reducing antibiotic use, prompting the search for new strategies. Convincing general practitioners to resist antibiotic prescription amid uncertainty or patient demands usually poses a significant challenge. Despite common practice, standard durations for common infections lack support from clinical studies. Contrary to common belief, extending antibiotic treatment beyond the resolution of symptoms does not seem to prevent or reduce antimicrobial resistance. Shortening the duration of antibiotic therapy has shown to be effective in mitigating the spread of resistance, particularly in cases of pneumonia. Recent hospital randomised trials suggest that ending antibiotic courses by day three for most lower respiratory tract infections is effective and safe. While community studies are scarce, it is likely that these shorter, tailored courses to meet patients' needs would also be effective and safe in primary care. Therefore, primary care studies should investigate the outcomes of advising patients to discontinue antibiotic treatment upon symptom resolution. Implementing patient-centred, customised treatment durations, rather than fixed courses, is crucial for meeting individual patient needs.

Original languageEnglish
Article number102723
JournalEClinicalMedicine
Volume74
Number of pages7
ISSN2589-5370
DOIs
Publication statusPublished - 2024

Bibliographical note

Publisher Copyright:
© 2024 The Authors

    Research areas

  • Anti-bacterial agents, Drug resistance, Duration of therapy, Microbial, Patient-centered care, Primary health care, Respiratory tract infections

ID: 398961396