The CLAHRC WM Director was always taught at Medical School to provide long courses of antibiotics (7–10 days) and try to maximise compliance throughout. This was thought to reduce the emergence of resistance. Hedrick et al. add to the evidence that short courses are less likely to result in antimicrobial resistance. So what’s best for the patient – a fixed short course or wait until the patient ‘responds’? Surprisingly, no difference in outcome was observed in Hedrick’s study. This would explain why the physiological response to infection appears to outlast the effective phase for antibiotic effectiveness. Most of the symptoms of infection result from the immune response to infection, not the infection itself. The CLAHRC WM Director hypothesises that persistence of symptoms beyond the effective phase of antibiotic use is caused by the bodies ‘mopping up’ exercise, where the immune system is eradicating dead or damaged bacteria.
— Richard Lilford, CLAHRC WM Director
- Hedrick TL, Evans HL, Smoth RL, et al. Can we define the ideal duration of antibiotic therapy? Surg Infect. 2006; 7(5): 419-432.