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July 27, 2021

Shorter Courses of Antibiotics for Urinary Tract Infection in Men

Author Affiliations
  • 1Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore
  • 2VA Maryland Healthcare System, Baltimore
JAMA. 2021;326(4):309-310. doi:10.1001/jama.2021.11120

Historically antibiotics were seen as miracle drugs. Over the past 70 years of widespread antibiotic use, however, there has been increasing recognition of some of the downsides of these drugs, including adverse effects and antimicrobial resistance. This awareness has prompted reconsideration of how to best use antibiotics including limiting use by disease indication or duration.1-3 Antibiotic durations for common infections were initially based on pathophysiology, expert opinion, and small observational studies. Recent clinical trials that randomly assigned patients to shorter courses or oral antibiotics for treatment of infections such as bone and joint infection or bacteremia have largely found noninferiority for achieving resolution of infection compared with standard dosing practice.1,3,4 This re-evaluation of antibiotic duration has aligned with a general trend reconsidering the “more is better” approach to clinical medicine.5

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