Optimal antimicrobial duration for common bacterial infections

Abstract

Most antibiotic use in Australia arises from prescriptions in the community. The risk of antibiotic-related adverse events, including resistance, increases with longer treatment courses. When antibiotics are indicated for treatment, short courses are as effective as standard ones for most common infections. Therapeutic Guidelines: Antibiotic is a key reference for antimicrobial prescribing in Australia. General practitioners play a key role in reducing antibiotic use. Antibiotic. 8 While other resources are commonly used, such as the Australian Medicines Handbook and MIMS, it is Therapeutic Guidelines that offers comprehensive information on the clinical indications for antibiotic prescription and advice on antibiotic choice, dose and duration. It is also the guideline currently endorsed by the Australian Commission on Safety and Quality in Health Care as the preferred reference for prescribing in the absence of local guidelines. Antimicrobials are not always needed Antibiotics are not necessary for most acute respiratory infections including acute rhinosinusitis, acute sore throat and acute otitis media. This is not just because so many of these infections are viral, but because even when the infection is bacterial, the benefits of antibiotic therapy for most patients are modest and outweighed by the harm from adverse effects. 9-12 Australian and local guidelines provide recommendations on when antimicrobial therapy should be used for these conditions. 8,13

Concordance with antibiotic guidelines in Australian primary care: A retrospective study of prior‐to‐hospital therapy

“…Collecting the same amount of data in primary care would require involvement of multiple GP practices, who would each have needed to provide consent; this approach may not have provided a representative sample, as some prescribers may be reluctant to allow their prescribing to be scrutinised. Furthermore, the indication for antibiotic therapy is not always documented in primary care records, and the desirability of this was recently highlighted in the Australian literature …”

“…Furthermore, the indication for antibiotic therapy is not always documented in primary care records, and the desirability of this was recently highlighted in the Australian literature. 54 As with all research using medical records as the data source, there is a risk that documentation may not be a comprehensive and true record: this applies to our project. Additionally, concordance was assessed against the diagnosis included in the medical records, and this was assumed to be the same diagnosis as when the priorto-hospital therapy was prescribed.…”

Penicillin: getting prescribing right for children

“…Many common, uncomplicated infections may be treated with shorter antibiotic courses than are commonly given. 9 …”

New label for antibiotics

“…There is now awareness that the required duration of treatment may need a smaller quantity of antibiotic than the pack that is supplied to the patient. 1,2 In consultation with other organisations, the Pharmaceutical Society of Australia has revised the cautionary advisory label used by pharmacists for antibiotics. It will now state, 'Take for the number of days advised by your prescriber.…”