The increase in antibiotic resistance and the lack of new antibiotics is currently a major global health problem.
Reducing the use of antibiotics appears to be one of the only solutions to preserve their effectiveness and limit the emergence of resistance.
Relatively long courses of treatment remain standard, however, although they seem to be based on medical tradition rather than on sound scientific evidence.
For example, in the case of bacteraemia, a common but potentially dangerous bloodstream infection, it is common practice to automatically prescribe a 14-day course of antibacterial treatment.
In a new study, researchers wanted to test, in more than 500 patients, whether a shorter treatment, which therefore would be less likely to select for resistance, was possible.
They found that a treatment duration reduced by half is equally effective.
In addition, the scientists demonstrate that tailoring the antibiotic regimen to each patient’s individual characteristics and disease patterns would allow the drug dose to be reduced even further without loss of therapeutic benefit.
This work leads to new recommendations aimed at promoting the rational use of antibiotics, which remain our best weapons against bacteria responsible for many diseases.
The research was conducted by a team from the University of Geneva (UNIGE) and elsewhere.
The team says the work also shows that it is possible to customize treatment for each patient.
This requires a daily measurement of CRP—a protein present in the blood that marks inflammation—a routine test that is carried out anyway in the case of bacteraemia.
In addition, the team identified certain risk factors: older age, in particular, as well as the pathogen involved.
Escherichia coli is indeed more easily eliminated than other bacteria, regardless of the duration of treatment.
The principle of ‘one size fits all’ is less and less true in medicine, and the characterization of biomarkers of inflammation could lead to truly personalized treatments while limiting the risk of resistance.
As a first step, the study can already recommend reducing the treatment of bacterial bloodstream infections to seven days.
The study is published in JAMA.
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