Shorter Course of Antibiotics Effective for Pneumonia

By Steven Reinberg
HealthDay Reporter

THURSDAY, June 8 (HealthDay News) -- Taking antibiotics for three days instead of the usual seven to 10 days is just as effective in treating common pneumonia , Dutch researchers report.

This shorter course of antibiotic treatment may also help contain the growing problem of antibiotic-resistant bacteria, the researchers say.

"The question is how long you should treat common pneumonia," said lead researcher Dr. Jan M Prins, an internist in infectious diseases at the Academic Medical Center, in Amsterdam. "It turns out that three days is sufficient in children, and we now find the same in adults," he added.

In the study, Prins's team compared the effectiveness of three days of amoxicillin treatment with eight days of treatment in adults with mild to moderate-severe pneumonia.

The researchers looked at 119 patients who improved after three days of treatment with intravenous amoxicillin, and then randomly assigned them to oral amoxicillin or a placebo for five days.

Among patients treated for three day or eight days, 93 percent got better, the researchers report. "For patients who responded after three days of antibiotic treatment, you could stop antibiotics and the results were comparable for those treated for eight days," Prins said.

The advantage, according to Prins, is that patients don't take more medication than necessary. "In addition, there is a relation between how many antibiotics are used in a community and the rate of resistance among bacteria," he said. "If you can reduce the use of antibiotics, you can reduce the rate of resistance."

The study findings appear in the June 10 issue of the British Medical Journal.

Prins cautioned that not all diseases treated with antibiotics will be candidates for short-course treatment. "In other conditions, we know you have to treat for 10 days or so," he said.

One expert thinks that not enough is known about how long antibiotics should be administered.

"There is a lack of clear evidence to allow clinicians to know the optimal duration of antibiotic therapy for many common infections," said Dr. John Paul, from the Royal Sussex County Hospital, in England, and author of an accompanying editorial in the journal.

"We know that some infections do require long-term therapy to prevent relapse. We know for others that short courses of antibiotics are as good as long courses," Paul said.

More studies are needed to determine when short-course therapy is called for, Paul said. "Although the consensus among microbiology/infectious disease specialists is that long-course therapy is the choice, you will still find plenty of clinicians who use personal experience to argue for short-course therapy," he said.

Another expert agrees that the short-course approach has merit.

"This concept is smart," said Philip Tierno Jr., director of clinical microbiology and immunology at New York University Medical Center. "It eliminates three big problems: The cost to individuals of some of these newer antibiotics, adverse reactions and complications, and the development of resistance."