Short-course antibiotic therapy for infections with a single causative pathogen.

Studies evaluating short-course therapy have focused on prevalent infections with demonstrable aetiology. Metaanalyses of clinical trials demonstrate that uncomplicated acute otitis media in children can be successfully treated with a 5-day course of cefuroxime axetil. In the treatment of tonsillopharyngitis, 4 - 5-day courses of oral cephalosporins compared favourably with the standard 10-day penicillin V regimen. The clinical cure rate and the bacteriological eradication rate were both significantly higher for cephalosporins than for penicillin V. Bacteriological failure rates for cephalosporins were about half those for penicillin. In studies on acute bacterial exacerbations of chronic bronchitis, no difference in the clinical cure rates or relapse rates was found between short-course therapy using cephalosporins and standard courses. The short courses had the advantage of improved gastrointestinal tolerance compared with longer durations of treatment. The results suggest that new short-course dosing regimens are viable and may be favourable in terms of increased tolerability, reduction in healthcare costs, enhanced patient compliance and the control of the development of antibiotic resistance.