“Other than tuberculosis …. for every bacterial infection for which trials have compared short -course with longer course antibiotic therapy, short-course therapy has been just as effective…” Spellberg, JAMA Intern Med. 2016;176(9):1254-1255 Using NORS data to optimise duration of antibiotic therapy in OPAT John Williams Consultant ID Physician, South Tees Hospitals NHS Trust William Dobell Medical Student, Newcastle University
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“Other than tuberculosis …. for every bacterial infection for which trials have
compared short-course with longer course antibiotic therapy, short-course
therapy has been just as effective…”
Spellberg, JAMA Intern Med. 2016;176(9):1254-1255
Using NORS data to optimise duration of antibiotic therapy in OPAT
John WilliamsConsultant ID Physician, South Tees Hospitals NHS Trust
William DobellMedical Student, Newcastle University
Why Reduce Antibiotic Usage?
Pros ConsReduced Cost Treatment FailureAnti-Microbial ResistanceReduced risk of AdverseEffects
“Antibiotics should be used for the shortest duration possible that gives an appropriate
clinical outcome.”
- Public Health England, 2015
“We will reduce inappropriate antibiotic prescribing by 50%, with the aim of being a
world leader in reducing prescribing by 2020.”
- HM Government, 2016
Guidelines
Primary Infective Diagnosis Duration of Treatment
Guidelines Source
Psoas Abscess - No None
Pelvic Abscess - No None
Vertebral Osteomyelitis with metalwork No Peer Reviewed Journal
Vascular Graft Infection No Peer Reviewed Journal
Respiratory Tract Infection – Other Variable No ESCMID
Osteomyelitis – non-surgical 2-4 weeks No Peer Reviewed Journal
Endocarditis Variable No BMJ Best Practice
Osteomyelitis – Surgical 6-8 weeks No Peer Reviewed Journal
GuidelinesPrimary Infective Diagnosis Duration of
TreatmentGuidelines Source
Epidural Abscess 6-12 weeks Yes BMJ Best Practice
Line Related Infection 7-14 days Yes ESCMID
Non-Tuberculous Mycobacteria >12 months Yes British Thoracic Society
Empyema >3 weeks Yes BMJ Best Practice
Cerebral Abscess >6 weeks Yes BMJ Best Practice
Intra-abdominal abscess >4 days Yes BMJ Best Practice
Bacterial Meningitis Variable Yes BMJ Best Practice