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Duration of antibiotic treatment for respiratory tract infections in primary care

Carl Llor1,2,3, Malene Plejdrup Hansen3,4, Jesper Lykkegaard3

  • 1University Institute in Primary Care Research Jordi Gol, Barcelona, Spain.

Jac-Antimicrobial Resistance
|February 26, 2025
PubMed
Abstract

Insights

Antibiotic courses for acute respiratory tract infections (RTIs) in primary care are often too long, contributing to antimicrobial resistance. Reducing antibiotic exposure by shortening treatment durations is crucial for public health.

Area of Science:

  • Public Health
  • Infectious Diseases
  • Pharmacology

Background:

  • Antimicrobial resistance (AMR) is a significant global health threat.
  • Excessive antibiotic use is the primary driver of AMR.
  • Reducing individual antibiotic exposure is key to combating AMR.

Purpose of the Study:

  • To assess the duration of antibiotic courses prescribed for acute respiratory tract infections (RTIs) in primary care settings.
  • To evaluate antibiotic prescribing patterns in relation to RTI diagnosis and recommended treatment durations.

Main Methods:

  • Prospective study including patients with RTI symptoms from primary care and out-of-hours services in five European countries.
  • Data collected via paper-based template, recording patient demographics, RTI diagnosis, antibiotic type, and treatment duration.
  • Analysis of 11,270 cases registered by 196 clinicians over two winter periods (2022-2023).

Main Results:

  • 34% of patients with RTIs received antibiotics, with a mean course duration of 7.52 days.
  • Longer durations were observed for pneumonia (8.01 days), COVID-19 (8.00 days), and pharyngotonsillitis (7.74 days).
  • Shorter durations were noted for viral infections like the common cold (6.32 days). 26.7% of courses were prescribed for 10 days or longer.

Conclusions:

  • Antibiotic courses for common RTIs are frequently prolonged beyond recommended durations.
  • Antibiotic use should be avoided for predominantly viral infections.
  • If antibiotics are necessary, course durations should be substantially reduced to minimize exposure and combat AMR.

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