A seven-day course of antibiotics is no less effective than a 14-day course for resolving urinary tract infections (UTI) in men with no fever, a new study finds.
More than 270 male study participants in U.S. Veterans Affairs medical centers were treated with ciprofloxacin or trimethoprim/sulfamethoxazole for presumed symptomatic UTI. All participants continued the antibiotic prescribed by their clinician for seven days and then were randomized to continue receiving either antibiotic therapy or placebo for 14 days of treatment.
The aim was to eliminate UTI symptoms by 14 days after completing active antibiotic treatment. When the results were analyzed, symptoms resolved in 93% of participants in the seven-day group compared with 90% in the two-week group. The findings support the use of a shorter course of ciprofloxacin or trimethoprim/ sulfamethoxazole in these cases, Dimitri M. Drekonja, M.D., of the University of Minnesota Medical School, and colleagues concluded.
This re-evaluation of antibiotic duration aligns with a trend toward reconsidering the “more is better” approach to clinical medicine, according to the authors of an accompanying editorial.
“Shorter courses of antibiotic treatment are inherently easier for patients and are preferred when clinical outcomes are noninferior compared with longer duration of treatment,” they wrote. “This study should inform guidelines and should give clinicians confidence to treat thoughtfully for the shortest effective treatment duration.”
Full findings were published in JAMA.
