Are we over-dosing on antibiotics?

Jun 12 2006

Dutch researchers say that a three day course of antibiotics is just as effective as the usual seven to 10 days course when it comes to treating common pneumonia.

The researchers believe that a shorter course of antibiotic treatment may also help curtail the growing problem of antibiotic-resistant bacteria.

Lead researcher Dr. Jan M Prins, an internist in infectious diseases at the Academic Medical Center, in Amsterdam says it appears that three days of medication is sufficient in children, and it now appears to be the same for adults with mild to moderate-severe community acquired pneumonia.

For the study, Prins's team looked at nine hospitals in the Netherlands and compared the effectiveness of three days of amoxicillin treatment with eight days of treatment in adults with mild to moderate-severe pneumonia.

The researchers monitored 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.

The researchers found that of the patients treated for three day or eight days, 93 percent got better.

But they also found that for patients who responded after three days of antibiotic treatment, when the antibiotics were stopped and the results were comparable for those treated for eight days.

According to Prins, the advantage is that patients only take as much medication as they need.

He says there is a relationship between how many antibiotics are used in a community and the rate of resistance among bacteria, and if the use of antibiotics can be reduced the rate of resistance can also be reduced.

Prins does caution that not all diseases treated with antibiotics will be candidates for short-course treatment and in some conditions treatment for 10 days is needed.

Other experts believe there is not enough evidence on how long antibiotics should be given and say some infections require long-term therapy to prevent relapse.

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