Question special
Lead Moderator

The authors propose that shortening courses of antibiotics rather than “completing the course” may actually decrease development of resistance. The data cited for ventilator associated pneumonia (VAP) draws from randomized trials (1, 2), but the data for other bacterial infections seems less robust (3). Can we extrapolate these findings to suggest that shortened courses of antibiotics decrease development of resistance in infections other than VAP, or is more research needed?

1. Chastre J, Wolff M, Fagon JY, et al. Comparison of 8 vs 15 days of antibiotic therapy for ventilator-associated pneumonia in adults: a randomized trial. Jama 2003;290:2588-98.
2. 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. American journal of respiratory and critical care medicine 2000;162:505-11.
3. Costelloe C, Metcalfe C, Lovering A, Mant D, Hay AD. Effect of antibiotic prescribing in primary care on antimicrobial resistance in individual patients: systematic review and meta-analysis. BMJ (Clinical research ed) 2010;340:c2096