Infectious disease experts rethink length of antibiotic treatment


Physicians who prescribe patients more than three days of antibiotics may be doing more harm than good.

But this advice is wrong, said Louis Rice, M.D., of Louis Stokes Cleveland VA Medical Center and Case Western Reserve University, during a lecture at the annual conference of the Infectious Diseases Society of America held in San Diego recently. Physicians who prescribe more than three days of antibiotics for the treatment of pneumonia, for example, may be putting patients at greater risk, Rice said during his presentation, "For the Duration: Rational Antibiotic Administration in an Era of Resistance and Clostridium difficile."

C. difficile-associated disease (CDAD) is a form of infectious diarrhea, and hospitals around the country continue to report increased concerns about infections among patients. U.S. hospital discharge data from the Centers for Disease Control & Prevention report that diagnoses of CDAD doubled from 82,000 in 1996 to 178,000 in 2003.

L. Clifford McDonald, M.D., a CDC medical epidemiologist speaking at the IDSA meeting, said that recent increases in rates and severity of CDAD may be attributed to a strain known as type BI, North American Pulsed-Field Type 1, and PCR-ribotype 027 (BI/NAP1/027). The strain shows increased resistance to fluoroquinolones and cephalosporins and carries an extra toxin known as binary toxin.

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