Unneeded antibiotics for acute respiratory infections in primary care: stop as early as possible

Abstract

In the field of antibiotic treatment, some old dogmas are falling in the light of recent evidence. Some examples include the need to use bactericidal drugs or their intravenous administration for the whole treatment course, and the durations of treatment for specific types of infections, among others [1–3]. The long recommended practice to complete the course of an antibiotic once prescribed [4] was also based on the dogma that not doing so would promote the development of resistance. Again, this dogma has also been seriously challenged, as present knowledge suggests that antibiotics facilitate resistance mostly by selecting resistant bacteria from the colonizing flora, that the longer the exposure the bigger collateral damage and that the development of resistance of the bacteria causing the infection being treated is relevant only for some pathogens and situations [5,6].