scholarly journals Short-Course Antibiotic Treatment Is Not Inferior to a Long-Course One in Acute Cholangitis: A Systematic Review

2018 ◽  
Vol 64 (2) ◽  
pp. 307-315 ◽  
Author(s):  
Benedek Tinusz ◽  
László Szapáry ◽  
Bence Paládi ◽  
Judit Tenk ◽  
Zoltán Rumbus ◽  
...  
Keyword(s):  
Systematic Review ◽  
Antibiotic Treatment ◽  
Acute Cholangitis ◽  
Short Course ◽  
Long Course

scholarly journals Antibiotic treatment duration for patients with bloodstream infection: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Yuting Li ◽  
Juan Yang ◽  
Hongmei Yang ◽  
Jianxing Guo ◽  
Dong Zhang
Keyword(s):  
Systematic Review ◽  
Antibiotic Treatment ◽  
Primary Outcome ◽  
Meta Analysis ◽  
Source Control ◽  
Short Course ◽  
Significant Difference ◽  
All Cause Mortality ◽  
Secondary Outcomes ◽  
Long Course

Abstract Objectives: The optimal duration of therapy for primary bloodstream infection (BSI) and BSI secondary to major organ system infections has been poorly defined. A systematic review and meta-analysis was performed to evaluate the impact of short (≤10 days)and long course(>10 days) of antibiotic treatment on clinical outcomes in patients with BSI.Methods: We searched the PubMed, Cochrane, and Embase databases for randomized controlled trials(RCTs) and cohort studies from inception to the 1st of October 2020. We included studies involving patients with BSI. All authors reported our primary outcome of all-cause mortality and clearly comparing short versus long course of antibiotic treatment with clinically relevant secondary outcomes(source control and relapse). Results were expressed as odds ratio (OR) with accompanying 95% confidence interval (CI).Results: Six studies including 3593 patients were included. The primary outcome of this meta-analysis showed that there was no statistically significant difference in the all-cause mortality between two groups (OR=1.10; 95% CI, 0.82 to 1.48; P=0.52; Chi2=7.57; I2=34%) . Secondary outcomes demonstrated that there was no statistically significant difference in the source control(OR=0.82; 95% CI, 0.61 to 1.10; P=0.18; Chi2=2.68; I2=25%)and relapse(OR=1.20; 95%CI,0.71 to 2.01; P=0.49; Chi2=0.26; I2=0%) between two groups. Conclusions: Short course of antibiotic treatment is not associated with either an increased risk of mortality or an increased odds of relapse compared with longer antibiotic treatment course for BSI. Furthermore, short course of antibiotic therapy is non-inferior to long course in terms of source control. Further large-scale RCTs are still required to confirm these results.

scholarly journals Short- vs. Long-Course Antibiotic Treatment for Acute Streptococcal Pharyngitis: Systematic Review and Meta-Analysis of Randomized Controlled Trials

Antibiotics ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. 733
Author(s):  
Anna Engell Holm ◽  
Carl Llor ◽  
Lars Bjerrum ◽  
Gloria Cordoba
Keyword(s):  
Antibiotic Therapy ◽  
Randomized Controlled Trials ◽  
Antibiotic Treatment ◽  
Clinical Cure ◽  
Randomized Clinical Trials ◽  
Streptococcal Pharyngitis ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Short Course ◽  
Long Course

BACKGROUND: To evaluate the effectiveness of short courses of antibiotic therapy for patients with acute streptococcal pharyngitis. METHODS: Randomized controlled trials comparing short-course antibiotic therapy (≤5 days) with long-course antibiotic therapy (≥7 days) for patients with streptococcal pharyngitis were included. Two primary outcomes: early clinical cure and early bacterial eradication. RESULTS: Fifty randomized clinical trials were included. Overall, short-course antibiotic treatment was as effective as long-course antibiotic treatment for early clinical cure (odds ratio (OR) 0.85; 95% confidence interval (CI) 0.79 to 1.15). Subgroup analysis showed that short-course penicillin was less effective for early clinical cure (OR 0.43; 95% CI, 0.23 to 0.82) and bacteriological eradication (OR 0.34; 95% CI, 0.19 to 0.61) in comparison to long-course penicillin. Short-course macrolides were equally effective, compared to long-course penicillin. Finally, short-course cephalosporin was more effective for early clinical cure (OR 1.48; 95% CI, 1.11 to 1.96) and early microbiological cure (OR 1.60; 95% CI, 1.13 to 2.27) in comparison to long-course penicillin. In total, 1211 (17.7%) participants assigned to short-course antibiotic therapy, and 893 (12.3%) cases assigned to long-course, developed adverse events (OR 1.35; 95% CI, 1.08 to 1.68). CONCLUSIONS: Macrolides and cephalosporins belong to the list of “Highest Priority Critically Important Antimicrobials”; hence, long-course penicillin V should remain as the first line antibiotic for the management of patients with streptococcal pharyngitis as far as the benefits of using these two types of antibiotics do not outweigh the harms of their unnecessary use.

scholarly journals Short‐course vs long‐course antibiotic treatment for community‐acquired pneumonia: A literature review

2019 ◽  
Vol 124 (5) ◽  
pp. 550-559 ◽  
Author(s):  
Kamilla Møller Gundersen ◽  
Jette Nygaard Jensen ◽  
Lars Bjerrum ◽  
Malene Plejdrup Hansen
Keyword(s):  
Literature Review ◽  
Antibiotic Treatment ◽  
Community Acquired Pneumonia ◽  
Short Course ◽  
Long Course

scholarly journals Shortening Antibiotic Duration in the Treatment of Acute Cholangitis. Rationale and Study Protocol for an Open Label Randomized Controlled Trial.

2019 ◽  
Author(s):  
Kentaro Iwata ◽  
Asako Doi ◽  
Yuichiro Oba ◽  
Hiroo Matsuo ◽  
Kei Ebisawa ◽  
...  
Keyword(s):  
Antimicrobial Therapy ◽  
Controlled Trial ◽  
Acute Cholangitis ◽  
Length Of Hospital Stay ◽  
Standard Of Care ◽  
Total Sample ◽  
Open Label ◽  
Short Course ◽  
Antibiotic Duration ◽  
Long Course

Abstract Background: Antimicrobial therapy with appropriate biliary drainage is considered the standard of care of acute cholangitis, but the optimal duration of antimicrobial therapy remains unknown. Seven to 10 days of antimicrobial therapy is common for the treatment of acute cholangitis, but recent retrospective cohort study suggested shorter duration might be effective enough. Shorter duration of antimicrobial therapy can be beneficial in decreasing the length of hospital stay, improving patients’ quality of life, decreasing adverse effects, and even contributing to decrease in the occurrence of antimicrobial resistance. Methods/design: We will conduct a multi-center, open-label, randomized, non-inferiority trial to compare short course therapy (SCT) with conventional long course therapy (LCT) in treating patients with acute cholangitis. SCT consists of 5-day intravenous antimicrobial therapy if the patients had clinical improvement, while at least 7 days of intravenous antibiotics will be provided to LCT group. The primary outcome is clinical cure at 30 days after their onset. Patients will be randomly assigned with open label fashion. A total sample size of 150 was estimated to provide a power of 80% with a one-sided alpha level of 2.5% and a non-inferiority margin of 10%. Discussion: This trial is expected to reveal whether SCT is non-inferior to conventional LCT or not, and may provide evidence that one can able to shorten the treatment duration for acute cholangitis for the benefit of the patients.

scholarly journals A Systematic Review and Meta-analysis of Antibiotic Treatment Duration for Bacteremia Due to Enterobacteriaceae

2019 ◽  
Vol 63 (5) ◽  
Author(s):  
Giannoula S. Tansarli ◽  
Nikolaos Andreatos ◽  
Elina E. Pliakos ◽  
Eleftherios Mylonakis
Keyword(s):  
Clinical Outcomes ◽  
Antibiotic Treatment ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Content Type ◽  
Randomized Controlled ◽  
Short Course ◽  
All Cause Mortality ◽  
Retrospective Cohort Studies ◽  
Long Course

ABSTRACT The duration of antibiotic therapy for bacteremia due to Enterobacteriaceae is not well defined. We sought to evaluate the clinical outcomes with shorter- versus longer-course treatment. We performed a systematic search of the PubMed and EMBASE databases through May 2018. Studies presenting comparative outcomes between patients receiving antibiotic treatment for ≤10 days (“short-course”) and those treated for >10 days (“long-course”) were considered eligible. Four retrospective cohort studies and one randomized controlled trial comprising 2,865 patients met the inclusion criteria. The short- and long-course antibiotic treatments did not differ in 30-day all-cause mortality (1,374 patients; risk ratio [RR] = 0.99; 95% confidence interval [CI], 0.69 to 1.43), 90-day all-cause mortality (1,750 patients; RR = 1.16; 95% CI, 0.81 to 1.66), clinical cure (1,080 patients; RR = 1.02; 95% CI, 0.96 to 1.08), or relapse at 90 days (1,750 patients; RR = 1.08; 95% CI, 0.69 to 1.67). In patients with bacteremia due to Enterobacteriaceae, the short- and long-course antibiotic treatments did not differ significantly in terms of clinical outcomes. Further well-designed studies are needed before treatment for 10 days or less is adopted in clinical practice.

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