Short-course antimicrobial therapy of respiratory tract infections

Accumulating evidence suggests that short-course (/=80%) of patients. However, more research is clearly needed in the subpopulations of children <2 years of age and in those with unresponsive/recurrent disease, since short-course therapy may not be successful in the majority of these patients. In sinusitis, most short-course therapy data have involved maxillary disease in adult patients. Regimens have included 3 days of azithromycin or cotrimoxazole (trimethoprim/sulfamethoxazole) or 5 days of cefpodoxime, telithromycin, gatifloxacin, gemifloxacin or amoxicillin/clavulanic acid. Preliminary results are encouraging but more study is clearly needed, especially in the paediatric population. In acute bacterial exacerbations of chronic bronchitis, short-course therapy with a variety of cephalosporins, second-generation fluoroquinolones and advanced generation macrolides/azalides/ketolides are all reasonable alternatives to traditional 7- to 14-day therapies. Cost containment in antimicrobial therapy should involve consideration of short-course therapy in the management of the most common types of respiratory tract infections.