The Use of Long-term Antibiotics for Suppression of Bacterial Infections

Area of Science:

• Infectious Diseases
• Pharmacology
• Clinical Medicine

Background:

• Suppressive antibiotic therapy is used for infections presumed incurable by standard treatment or source control.
• Patients often have comorbidities and retained prosthetic material, necessitating prolonged or indefinite antibiotic courses.
• Lack of clear guidelines contributes to extended antibiotic use, with poorly characterized risks.

Purpose of the Study:

• To review evidence for suppressive antibiotic therapy in four common indications.
• To identify gaps in the current literature regarding its use.
• To explore the known and potential risks associated with prolonged antibiotic exposure.

Main Methods:

• Narrative review of existing literature.
• Analysis of evidence for suppressive antibiotic therapy in specific clinical scenarios.
• Examination of risks, including adverse drug effects, antibiotic resistance, and microbiome disruption.

Main Results:

• Evidence for suppressive antibiotic therapy in four common indications was presented.
• Gaps in the current literature were identified.
• Known and potential risks of prolonged antibiotic exposure were explored.

Conclusions:

• Suppressive antibiotic therapy is a complex treatment for hard-to-treat infections.
• Further research is needed to fully characterize risks and optimize treatment strategies.
• A standardized term for long-term suppressive antibiotic use is recommended to improve evidence quality.