Short-course versus long-course oral antibiotic treatment for infections treated in outpatient settings: A review of systematic reviews

Elizabeth E. Dawson-Hahn, Sharon Mickan, Igho Onakpoya, Nia Roberts, Matthew Kronman, Chris C. Butler, Matthew J. Thompson

Research output: Contribution to journalReview articleResearchpeer-review

13 Citations (Scopus)

Abstract

Purpose. To summarize the evidence comparing the effectiveness of short and long courses of oral antibiotics for infections treated in outpatient settings. Methods. We identified systematic reviews of randomized controlled trials for children and adults with bacterial infections treated in outpatient settings from Medline, Embase, CINAHL, Cochrane Database of Systematic Reviews and The Database of Review of Effects. Data were extracted on the primary outcome of clinical resolution and secondary outcomes. Results. We identified 30 potential reviews, and included 9. There was no difference in the clinical cure for children treated with short or long course antibiotics for Group A streptococcal tonsillopharyngitis (OR 1.03, 95% CI:0.97, 1.11); community acquired pneumonia (RR 0.99, 95% CI:0.97, 1.01); acute otitis media [<2 years old OR: 1.09 (95% CI:0.76, 1.57); ≥2 years old OR: 0.85 (95% CI:0.60, 1.21)]; or urinary tract infection (RR 1.06, 95% CI:0.64, 1.76). There was no difference in the clinical cure for adults treated with short or long course antibiotics for acute bacterial sinusitis (RR 0.95, 95% CI:0.81, 1.21); uncomplicated cystitis in non-pregnant women (RR 1.10, 95% CI:0.96, 1.25), or elderly women (RR: 0.98, 95% CI:0.62, 1.54); acute pyelonephritis (RR 1.03, 95% CI:0.80, 1.32); or community acquired pneumonia (RR: 0.96, 95% CI:0.74, 1.26). We found inadequate evidence about the effect on antibiotic resistance. Conclusions. This overview of systematic reviews has identified good quality evidence that short course antibiotics are as effective as longer courses for most common infections managed in ambulatory care. The impact on antibiotic resistance and associated treatment failure requires further study.

Original languageEnglish
Pages (from-to)511-519
Number of pages9
JournalFamily Practice
Volume34
Issue number5
DOIs
Publication statusPublished - 1 Oct 2017
Externally publishedYes

Fingerprint

Outpatients
Anti-Bacterial Agents
Microbial Drug Resistance
Infection
Pneumonia
Databases
Cystitis
Pyelonephritis
Sinusitis
Otitis Media
Therapeutics
Ambulatory Care
Treatment Failure
Bacterial Infections
Urinary Tract Infections
Randomized Controlled Trials

Cite this

Dawson-Hahn, Elizabeth E. ; Mickan, Sharon ; Onakpoya, Igho ; Roberts, Nia ; Kronman, Matthew ; Butler, Chris C. ; Thompson, Matthew J. / Short-course versus long-course oral antibiotic treatment for infections treated in outpatient settings : A review of systematic reviews. In: Family Practice. 2017 ; Vol. 34, No. 5. pp. 511-519.
@article{6b7892c52fca4799bd1784b1fbb84362,
title = "Short-course versus long-course oral antibiotic treatment for infections treated in outpatient settings: A review of systematic reviews",
abstract = "Purpose. To summarize the evidence comparing the effectiveness of short and long courses of oral antibiotics for infections treated in outpatient settings. Methods. We identified systematic reviews of randomized controlled trials for children and adults with bacterial infections treated in outpatient settings from Medline, Embase, CINAHL, Cochrane Database of Systematic Reviews and The Database of Review of Effects. Data were extracted on the primary outcome of clinical resolution and secondary outcomes. Results. We identified 30 potential reviews, and included 9. There was no difference in the clinical cure for children treated with short or long course antibiotics for Group A streptococcal tonsillopharyngitis (OR 1.03, 95{\%} CI:0.97, 1.11); community acquired pneumonia (RR 0.99, 95{\%} CI:0.97, 1.01); acute otitis media [<2 years old OR: 1.09 (95{\%} CI:0.76, 1.57); ≥2 years old OR: 0.85 (95{\%} CI:0.60, 1.21)]; or urinary tract infection (RR 1.06, 95{\%} CI:0.64, 1.76). There was no difference in the clinical cure for adults treated with short or long course antibiotics for acute bacterial sinusitis (RR 0.95, 95{\%} CI:0.81, 1.21); uncomplicated cystitis in non-pregnant women (RR 1.10, 95{\%} CI:0.96, 1.25), or elderly women (RR: 0.98, 95{\%} CI:0.62, 1.54); acute pyelonephritis (RR 1.03, 95{\%} CI:0.80, 1.32); or community acquired pneumonia (RR: 0.96, 95{\%} CI:0.74, 1.26). We found inadequate evidence about the effect on antibiotic resistance. Conclusions. This overview of systematic reviews has identified good quality evidence that short course antibiotics are as effective as longer courses for most common infections managed in ambulatory care. The impact on antibiotic resistance and associated treatment failure requires further study.",
author = "Dawson-Hahn, {Elizabeth E.} and Sharon Mickan and Igho Onakpoya and Nia Roberts and Matthew Kronman and Butler, {Chris C.} and Thompson, {Matthew J.}",
year = "2017",
month = "10",
day = "1",
doi = "10.1093/fampra/cmx037",
language = "English",
volume = "34",
pages = "511--519",
journal = "Family Practice",
issn = "0263-2136",
publisher = "OXFORD UNIV PRESS",
number = "5",

}

Short-course versus long-course oral antibiotic treatment for infections treated in outpatient settings : A review of systematic reviews. / Dawson-Hahn, Elizabeth E.; Mickan, Sharon; Onakpoya, Igho; Roberts, Nia; Kronman, Matthew; Butler, Chris C.; Thompson, Matthew J.

In: Family Practice, Vol. 34, No. 5, 01.10.2017, p. 511-519.

Research output: Contribution to journalReview articleResearchpeer-review

TY - JOUR

T1 - Short-course versus long-course oral antibiotic treatment for infections treated in outpatient settings

T2 - A review of systematic reviews

AU - Dawson-Hahn, Elizabeth E.

AU - Mickan, Sharon

AU - Onakpoya, Igho

AU - Roberts, Nia

AU - Kronman, Matthew

AU - Butler, Chris C.

AU - Thompson, Matthew J.

PY - 2017/10/1

Y1 - 2017/10/1

N2 - Purpose. To summarize the evidence comparing the effectiveness of short and long courses of oral antibiotics for infections treated in outpatient settings. Methods. We identified systematic reviews of randomized controlled trials for children and adults with bacterial infections treated in outpatient settings from Medline, Embase, CINAHL, Cochrane Database of Systematic Reviews and The Database of Review of Effects. Data were extracted on the primary outcome of clinical resolution and secondary outcomes. Results. We identified 30 potential reviews, and included 9. There was no difference in the clinical cure for children treated with short or long course antibiotics for Group A streptococcal tonsillopharyngitis (OR 1.03, 95% CI:0.97, 1.11); community acquired pneumonia (RR 0.99, 95% CI:0.97, 1.01); acute otitis media [<2 years old OR: 1.09 (95% CI:0.76, 1.57); ≥2 years old OR: 0.85 (95% CI:0.60, 1.21)]; or urinary tract infection (RR 1.06, 95% CI:0.64, 1.76). There was no difference in the clinical cure for adults treated with short or long course antibiotics for acute bacterial sinusitis (RR 0.95, 95% CI:0.81, 1.21); uncomplicated cystitis in non-pregnant women (RR 1.10, 95% CI:0.96, 1.25), or elderly women (RR: 0.98, 95% CI:0.62, 1.54); acute pyelonephritis (RR 1.03, 95% CI:0.80, 1.32); or community acquired pneumonia (RR: 0.96, 95% CI:0.74, 1.26). We found inadequate evidence about the effect on antibiotic resistance. Conclusions. This overview of systematic reviews has identified good quality evidence that short course antibiotics are as effective as longer courses for most common infections managed in ambulatory care. The impact on antibiotic resistance and associated treatment failure requires further study.

AB - Purpose. To summarize the evidence comparing the effectiveness of short and long courses of oral antibiotics for infections treated in outpatient settings. Methods. We identified systematic reviews of randomized controlled trials for children and adults with bacterial infections treated in outpatient settings from Medline, Embase, CINAHL, Cochrane Database of Systematic Reviews and The Database of Review of Effects. Data were extracted on the primary outcome of clinical resolution and secondary outcomes. Results. We identified 30 potential reviews, and included 9. There was no difference in the clinical cure for children treated with short or long course antibiotics for Group A streptococcal tonsillopharyngitis (OR 1.03, 95% CI:0.97, 1.11); community acquired pneumonia (RR 0.99, 95% CI:0.97, 1.01); acute otitis media [<2 years old OR: 1.09 (95% CI:0.76, 1.57); ≥2 years old OR: 0.85 (95% CI:0.60, 1.21)]; or urinary tract infection (RR 1.06, 95% CI:0.64, 1.76). There was no difference in the clinical cure for adults treated with short or long course antibiotics for acute bacterial sinusitis (RR 0.95, 95% CI:0.81, 1.21); uncomplicated cystitis in non-pregnant women (RR 1.10, 95% CI:0.96, 1.25), or elderly women (RR: 0.98, 95% CI:0.62, 1.54); acute pyelonephritis (RR 1.03, 95% CI:0.80, 1.32); or community acquired pneumonia (RR: 0.96, 95% CI:0.74, 1.26). We found inadequate evidence about the effect on antibiotic resistance. Conclusions. This overview of systematic reviews has identified good quality evidence that short course antibiotics are as effective as longer courses for most common infections managed in ambulatory care. The impact on antibiotic resistance and associated treatment failure requires further study.

UR - http://www.scopus.com/inward/record.url?scp=85029903319&partnerID=8YFLogxK

U2 - 10.1093/fampra/cmx037

DO - 10.1093/fampra/cmx037

M3 - Review article

VL - 34

SP - 511

EP - 519

JO - Family Practice

JF - Family Practice

SN - 0263-2136

IS - 5

ER -