Antibiotic Duration in Respiratory Infections: Short vs Long Courses, Antimicrobial Resistance, and Outcomes in a UK Secondary Care Study: Evidence from 640 Adults Across 2019–2020

This retrospective cross-sectional study investigated the appropriateness of shorter (≤5 days) and longer (6–7 days and >8 days) antibiotic regimens for respiratory infections in a UK secondary care setting. Data from 640 adult patients admitted during 2019–2020 were analysed to evaluate clinical outcomes, discharge rates, and potential risks associated with treatment duration. Findings demonstrated that shorter courses (≤5 days) were frequently associated with earlier patient discharge and were equally effective as longer regimens for conditions such as chronic obstructive pulmonary disease (COPD) exacerbations, COVID-19-related pneumonia, and hospital-acquired pneumonia (HAP). Exceptions included community-acquired pneumonia (CAP) and cases with unspecified diagnoses, where longer courses may still be necessary. Although an observed increase in mortality risk with shorter regimens was noted, this did not reach statistical significance and may have been influenced by the COVID-19 pandemic. The study underscores the importance of precise diagnosis, individualised prescribing, and careful risk assessment at admission. It supports the principle that “shorter is better” for many respiratory infections, while highlighting the need for further research with larger sample sizes to validate these findings. Optimising antibiotic duration is crucial for enhancing patient safety, reducing antimicrobial resistance, and safeguarding public health.