Duration of antibiotic treatment for common infections in English primary care: cross sectional analysis and comparison with guidelines

According to an editorial, this is one of two studies in the BMJ that highlight the daily challenge of ensuring that patients who are unlikely to benefit are not treated, whereas those who require antibiotics receive the right class, at the right time, at the right dose, and for the right duration. This task is made considerably more difficult by the absence of real-time microbiology in primary care. Both studies use invaluable routine NHS data.

It notes that this study builds on good evidence that “short” antibiotic courses are as effective as “long” courses for most infections treated in primary care. It acknowledges that prescribers cannot be held responsible for what they were doing before new guidelines were issued, but they can familiarise themselves with new guidance from NICE on managing common infections and optimise practice from here on. It adds that both clinicians and patients may need convincing to abandon longer courses of antibiotics, and future campaigns by Public Health England to “Keep Antibiotics Working” could usefully emphasise that when antibiotics are needed, shorter courses are sufficient to kill bacteria and less harmful than longer courses, and some symptoms should be expected to persist beyond the end of the course, in some cases for up to four weeks.