Cutting Down Antibiotic Treatment Time Helps Fight Bacterial Resistance

Physicians have always prescribed the standard treatment course of antibiotics for bacterial infections based on medical tradition. Now that antibiotic resistance has become a serious global health problem, researchers at the University of Geneva tested whether a shorter treatment, that is less likely to select for resistance, would have the same effect as the standard 14 day treatment course. The results of the study published in JAMA demonstrate that dividing the treatment duration in half, or even moving towards personalized treatment, does have the same outcome.

What is CRP and How Does the Test Play a Role in Bacterial Infections?

CRP stands for C-reactive protein and is a multifunctional molecule of the innate immune system in humans. This protein is made by the liver and is sent into our bloodstream. CRP can then be used as a biomarker for inflammation. Typically, when there is inflammation, CRP levels rise, which indicate infection. This information can be helpful in establishing the etiology of these infections.

Time Matters

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In this study, scientists designed a completely randomized clinical trial of 504 adults with uncomplicated gram-negative bacteremia, which is a bloodstream infection caused by gram-negative bacilli. Their main objective was to compare the clinical effectiveness of C-reactive protein-guided, 7-day treatment, and 14-day antibiotic durations 30, 60, and 90 days after start of treatment. You might be wondering what does C-reactive protein-guided antibiotic treatment mean? This simply means that the antibiotic treatment period was based on the patient’s level of inflammation. Once the individual’s CRP level had dropped from its peak by 75%, the patient was taken off treatment, whereas the other two groups received treatment for 7 and 14 days, respectively. Scientists were able to conclude that 30-day rates of clinical failure for CRP-guided antibiotic treatment duration and fixed 7-day treatment were noninferior to fixed 14-day treatment.

What we can expect moving forward is customizing treatment for patients, which would require daily measurements of CRP and allow for a lower drug dose while preserving therapeutic benefits. This is crucial in limiting the risk of antibiotic resistance.

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