A new study spearheaded by Bradley J. Langford at Public Health Ontario, in collaboration with the Dalla Lana School of Public Health, University of Toronto, has revealed that the duration of antibiotic courses does not significantly impact patient outcomes in seniors. Published online on December 30, 2024, in Clinical Infectious Diseases, the research utilized administrative health data from 2018 to examine how varying lengths of antibiotic therapy affected outpatients aged 66 to 110 years.
The study involved a comprehensive analysis of medical records from 117,682 seniors who received prescriptions for antibiotics such as amoxicillin, cephalexin, or ciprofloxacin. A total of 3868 prescribers contributed to the data pool, allowing researchers to compare the effects of longer antibiotic courses lasting 8-14 days against shorter ones spanning 3-7 days. The primary focus was to assess potential harms associated with antibiotic use, including adverse events within 21 days, Clostridioides difficile infections within 90 days, and the development of new antibiotic resistance within the same timeframe.
In their findings, the researchers determined that longer courses of antibiotics did not correlate with an increase in primary harm outcomes for any of the antibiotics studied. Specifically, amoxicillin had an adjusted odds ratio (aOR) of 0.99 (95% CI, 0.84-1.15), cephalexin had an aOR of 1.11 (95% CI, 0.90-1.38), and ciprofloxacin exhibited an odds ratio (OR) of 0.94 (95% CI, 0.74-1.20). These figures suggest that the duration of antibiotic treatment may have minimal effect on patient safety and resistance development.
"[The study] findings may suggest that in community-dwelling patients who are at lower risk of harms and benefits from antibiotic therapy, the impact of duration may be negligible," – The authors
Secondary outcomes of the study included detailed evaluations of the components of primary outcomes as well as safety measures. The research was supported by grants from the Ontario Ministry of Health and Ministry of Long-Term Care to the Institute for Clinical Evaluative Sciences and additional funding from Physician Services Inc. Foundation. Notably, artificial intelligence played a role in the editorial process for creating this article.
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