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Commentary: Excessive duration of antibiotic therapy in transition care

The duration of antibiotic therapy exceeded recommendations in 81% of patients according to a new study by a team from the pharmacy department, Ohio State University, Columbus.

The team retrospectively analysed the duration of antibiotic therapy for 101 patients discharged to the community from general surgery and general medical services at a large academic medical centre.

Included patients had one of the following diagnoses: uncomplicated urinary tract infection (uUTI), complicated (cUTI), community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP). The total duration of antibiotic therapy was calculated as the sum of the in-patient and outpatient prescriptions. Guideline recommended treatment durations were 3 days (uUTI), 5 days (CAP) and 7 days (cUTI and HAP). Overall, only 3% of patients had antibiotic treatment durations which met these recommendations with the median duration beyond guidelines being 4 (range 2 – 7) days.

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For example, the median duration was 5 days longer than recommended for cUTI and 2 and 3 days for CAP and HAP. In addition, more than 75% of patients received antibiotic courses exceeding 7 days, which on average, resulted in patients having 3.8 days of unnecessary antibiotics.

The authors suggest that hospital pharmacists have an important role to play in antibiotic stewardship by reviewing the duration of discharge prescriptions.

Brower KI et al. Duration of antibiotic therapy for general medicine and general surgery patients throughout transitions of care: an antibiotic stewardship opportunity for non-infectious disease pharmacists. Hospital Pharmacy 2020; June 14