Protecting patients by supporting safe and effective antibiotic prescribing.

Comparing treatment durations

Infections for which short-course therapy has been shown to have equivalent efficacy to longer therapy. Adapted from Spellberg B JAMA Internal Medicine July 2015

Infection	Treatment duration (days) Short	Treatment duration (days) Long	Reference (s)
Community-acquired pneumonia	3-5	7-10	1-3
Hospital acquired / Ventilator Associated pneumonia	3-8	10-15	4-5
Pyelonephritis	5-7	10-14	6-7
Intra-abdominal sepsis	4	10	8
Acute exacerbations of COPD	<=5	>=7	9
Cellulitis	5-6	10	10

Spellberg, B. (2016). The New Antibiotic Mantra—“Shorter Is Better”. JAMA Internal Medicine.

References
1) el Moussaoui R, de Borgie CA, van den Broek P, et al. Effectiveness of discontinuing antibiotictreatment after three days versus eight days in mild to moderate-severe community acquired pneumonia: randomised, double blind study. BMJ. 2006;332(7554):1355.
2)Dunbar LM,Wunderink RG, HabibMP, et al High-dose, short-course levofloxacin for community-acquired pneumonia: a new treatment paradigm. Clin Infect Dis. 2003;37(6):752-760.
3) Uranga A, España PP, Bilbao A, et al. Duration of antibiotic treatment in community-acquired pneumonia: a multicenter randomized clinical trial JAMA Internal Med.
4) Chastre J,Wolff M, Fagon JY, et al; PneumA Trial Group. Comparison of 8 vs 15 days of antibiotic therapy for ventilator-associated pneumonia in adults: a randomized trial. JAMA. 2003;290(19): 2588-2598.
5) Singh N, Rogers P, Atwood CW,Wagener MM, Yu VL. Short-course empiric antibiotic therapy for patients with pulmonary infiltrates in the intensive care unit: a proposed solution for indiscriminate antibiotic prescription. Am J Respir Crit Care Med. 2000;162(2, pt 1):505-511.
6) Eliakim-Raz N, Yahav D, Paul M, Leibovici L. Duration of antibiotic treatment for acute pyelonephritis and septic urinary tract infection—7 days or less versus longer treatment: systematic review and meta-analysis of randomized controlled trials. J Antimicrob Chemother. 2013;68(10): 2183-2191.
7) Kyriakidou KG, Radailidis P, Matthaiou DK, Athanasiou S and Falagas ME. Short- Versus Long-Course Antibiotic Therapy for Acute Pyelonephritis in Adolescents and Adults: A Meta-Analysis of Randomized Controlled Trials. Clin Therap 2008 Oct;30(10):1859-68.
8) Sawyer RG, Claridge JA, Nathens AB, et al. Trial of short-course antimicrobial therapy for intraabdominal infection. N Engl J Med. 2015; (21):1996-2005.
9) el Moussaoui R, Roede BM, Speelman P, Bresser P, Prins JM, Bossuyt PM. Short-course antibiotic treatment in acute exacerbations of chronic bronchitis and COPD: ameta-analysis of double-blind studies. Thorax. 2008;63(5):415-422.
10) Hepburn MJ, Dooley DP, Skidmore PJ, Ellis MW, Starnes WF, Hasewinkle WC. Comparison of short-course (5 days) and standard (10 days) treatment for uncomplicated cellulitis. Arch Intern Med. 2004;164(15):1669-1674.

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