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. 2025 Feb 25;7(1):dlaf028.
doi: 10.1093/jacamr/dlaf028. eCollection 2025 Feb.

Duration of antibiotic treatment for respiratory tract infections in primary care

Carl Llor  1   2   3 , Malene Plejdrup Hansen  3   4 , Jesper Lykkegaard  3 , Jonas Olsen  3 , Bent Håkan Lindberg  5   6 , Ingrid Keilegavlen Rebnord  7 , Pia Touboul Lundgren  8 , Pascale Bruno  8 , Anna Kowalczyk  9 , Christos Lionis  10 , Ruta Radzeviciene  11 , Lina Jaruseviciene  12 , Lars Bjerrum  13 , Ana García-Sangenís  1   2 ; HAPPY PATIENT Study Group
Collaborators, Affiliations

Duration of antibiotic treatment for respiratory tract infections in primary care

Carl Llor et al. JAC Antimicrob Resist. .

Abstract

Objectives: The primary driver of antimicrobial resistance is excessive antibiotic use, posing a global threat to public health. Reducing individual exposure to antibiotics is a key to addressing the problem. This study aimed to assess the duration of antibiotic courses administered to patients with acute respiratory tract infections (RTIs) in primary care.

Methods: Consecutive patients presenting with RTI symptoms were prospectively included from general practices and out-of-hours services in France, Greece, Lithuania, Poland and Spain for two winter periods (February to April 2022 and 2023). Data were collected using a paper-based Audit Project Odense template, with clinicians recording patient age, gender, RTI diagnosis, type of antibiotic prescribed and treatment duration.

Results: A total of 196 doctors (133 in general practice and 63 in out-of-hours services) registered 11 270 cases, with 34.0% (3835) receiving antibiotics. The mean antibiotic course duration was 7.52 days (SD 2.11), which was significantly longer for pneumonia, COVID-19 infection and pharyngotonsillitis (8.01, 8.00 and 7.74 days, respectively), and lowest for predominantly viral infections, such as the common cold and flu infection, laryngitis and acute bronchitis (6.32, 6.48 and 6.98 days, respectively; P < 0.001). A total of 26.7% of the courses were prescribed for 10 days or longer.

Conclusions: Antibiotic courses for common RTIs are often prolonged, which does not align with current recommendations for course duration. Antibiotics should be avoided in cases of predominantly viral infections and most mixed infections; however, if deemed necessary, the courses should be substantially reduced to minimize unnecessary exposure.

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Figures

Figure 1.
Figure 1.
Treatment duration by country and setting.
See this image and copyright information in PMC

References

    1. GBD 2021 Antimicrobial Resistance Collaborators . Global burden of bacterial antimicrobial resistance 1990–2021: a systematic analysis with forecasts to 2050. Lancet 2024; 404: 1199–226. 10.1016/S0140-6736(24)01867-1 - DOI - PMC - PubMed
    1. Antimicrobial Resistance Collaborators . Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. Lancet 2022; 399: 629–55. 10.1016/S0140-6736(21)02724-0 - DOI - PMC - PubMed
    1. Ramachandran P, Rachuri NK, Martha S et al. Implications of overprescription of antibiotics: a cross-sectional study. J Pharm Bioallied Sci 2019; 11 Suppl 2: S434–7. 10.4103/JPBS.JPBS_62_19 - DOI - PMC - PubMed
    1. Dolk FCK, Pouwels KB, Smith DRM et al. Antibiotics in primary care in England: which antibiotics are prescribed and for which conditions? J Antimicrob Chemother 2018; 73 Suppl 2: ii2–10. 10.1093/jac/dkx504 - DOI - PMC - PubMed
    1. Dyar OJ, Beović B, Vlahović-Palčevski V et al. How can we improve antibiotic prescribing in primary care? Expert Rev Anti Infect Ther 2016; 14: 403–13. 10.1586/14787210.2016.1151353 - DOI - PubMed

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