Short courses of antibiotic in acute otitis media and sinusitis infections

Abstract

Poor compliance with standard antibiotic regimens of 7 - 10 days' duration used in the treatment of acute upper respiratory tract infections contributes significantly to treatment failure. Patients fail to complete the recommended course of treatment, stopping once symptoms have resolved, which is typically within 2 - 5 days. Accumulating evidence from a large number of prospective clinical studies suggests that shortened courses of treatment may be as, or more, effective than conventional regimens of longer duration. As an example, a study comparing 5 days of cefuroxime axetil therapy with either 10 days of cefuroxime axetil or amoxycillin/clavulanate showed no differences in rates of clinical cure, bacteriological eradication and recurrence in paediatric patients with either acute otitis media or sinusitis. Shortened-course therapy with agents such as cefuroxime axetil has the potential to improve patient compliance and so reduce the rate of clinical failure and the emergence of resistant strains. Other potential benefits include fewer side-effects, improved patient satisfaction and lower treatment costs.