ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021
Shorter and Longer Courses of Antibiotics for Common Infections and the Association With Reductions of Infection-Related Complications Including Hospital Admissions.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Short- versus long-course of antimicrobial treatment in pediatric population with acute osteoarticular infections: a systematic review and meta-analysis.European journal of pediatrics · 2026Pooled it
- Antimicrobial interventions in multi drug resistance providencia associated infection; a systematic review and meta-analysis of case reports.BMC infectious diseases · 2026Pooled it
- ASP-COMPLEX: redefining antimicrobial stewardship to improve outcomes in high-risk patients with severe infections.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2026Review
- Antibiotic Use in the First 2 Years of Life Is Related to Longitudinal BMI Trajectories From 0 to 18 years: A Prospective Cohort Study.Journal of obesity · 2026Article
- Community pharmacists and outpatient antimicrobial stewardship: evidence, uncertainties, and future directions.Frontiers in health services · 2026Article
- The role of the community pharmacist in antibiotic use - a commentary on current status and future perspectives.Exploratory research in clinical and social pharmacy · 2025Article
- Tailoring Antibiotic Duration for Respiratory Tract Infections in Primary Care: Protocol for a Pragmatic Randomized Controlled Trial Study (STORM).JMIR research protocols · 2025Article
- Duration of antibiotic treatment for respiratory tract infections in primary care.JAC-antimicrobial resistance · 2025Article
- Systematic Review Protocol on Antibiotic Use for infection related Orofacial Pain: Policy and Practice Implications.F1000Research · 2025Article
- Duration of Antimicrobial Treatment in Adult Patients with Pneumonia: A Narrative Review.Antibiotics (Basel, Switzerland) · 2024Review
- Antibiotic-Induced Immunosuppression-A Focus on Cellular Immunity.Antibiotics (Basel, Switzerland) · 2024Review
- Stop antibiotics when you feel better? Opportunities, challenges and research directions.JAC-antimicrobial resistance · 2024Review
- Optimising antibiotic exposure by customising the duration of treatment for respiratory tract infections based on patient needs in primary care.EClinicalMedicine · 2024Review
- Shorter and Longer Antibiotic Durations for Respiratory Infections: To Fight Antimicrobial Resistance-A Retrospective Cross-Sectional Study in a Secondary Care Setting in the UK.Pharmaceuticals (Basel, Switzerland) · 2024Article
- Review
- A Study Review of the Appropriateness of Oral Antibiotic Discharge Prescriptions in the Emergency Department at a Rural Hospital in Mississippi, USA.Antibiotics (Basel, Switzerland) · 2023Article
- Can the Future of ID Escape the Inertial Dogma of Its Past? The Exemplars of Shorter Is Better and Oral Is the New IV.Open forum infectious diseases · 2023Article
- Article
- Compliance to Guidelines in Prescribing Empirical Antibiotics for Individuals with Uncomplicated Urinary Tract Infection in a Primary Health Facility of Ghana, 2019-2021.International journal of environmental research and public health · 2022Article
- Is shorter always better? The pros and cons of treating Gram-negative bloodstream infections with 7 days of antibiotics.JAC-antimicrobial resistance · 2022Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
backgroundAntimicrobial resistance is a serious global health concern that emphasizes completing treatment course. Recently, the effectiveness of short versus longer antibiotic courses has been questioned. This study investigated the duration of prescribed antibiotics, their effectiveness, and associated risk of infection-related complications.
methodsClinical Practice Research Datalink identified 4 million acute infection episodes prescribed an antibiotic in primary care between January 2014-June 2014, England. Prescriptions were categorized by duration. Risk of infection-related hospitalizations within 30 days was modelled overall and by infection type. Risk was assessed immediately after or within 30 days follow-up to measure confounders given similar and varying exposure, respectively. An interaction term with follow-up time assessed whether hazard ratios (HRs) remained parallel with different antibiotic durations.
resultsThe duration of antibiotic courses increased over the study period (5.2-19.1%); 6-7 days were most common (66.9%). Most infection-related hospitalizations occurred with prescriptions of 8-15 days (0.21%), accompanied by greater risk of infection-related complications compared to patients who received a short prescription (HR: 1.75 [95% CI: 1.54-2.00]). Comparing HRs in the first 5 days versus remaining follow-up showed longer antibiotic courses were no more effective than shorter courses (1.02 [95% CI: 0.90-1.16] and 0.92 [95% CI: 0.75-1.12]). No variation by infection-type was observed.
conclusionsEqual effectiveness was found between shorter and longer antibiotic courses and the reduction of infection-related hospitalizations. Stewardship programs should recommend shorter courses of antibiotics for acute infections. Further research is required for treating patients with a complex medical history.SummaryPrescribing of longer courses increased over the study period. The majority of hospitalizations occurred for patients receiving longer courses. Risk of developing a complication (immediate vs remaining follow-up) found longer courses were no more effective than shorter courses.
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