[Shortened antimicrobial therapy duration].

Abstract

SHORTENED ANTIMICROBIAL THERAPY DURATION. Antibiotic treatment durations represent an important field of current clinical research. Indeed, shortening antibiotic duration during bacterial pathologies has several advantages: reducing the emergence of resistance on an individual and collective scale, reducing costs, adverse effects and the environmental impact. However, a rigorous investigation is necessary to properly assess the absence of impact on the individual prognosis. In recent years, several randomized trials have made it possible to validate short durations of antibiotic therapy for frequent bacterial pathologies: 5 days during simple acute pyelonephritis, 7 days for non-febrile urinary tract infections in men, 3 to 5 days during acute bacterial pneumonia, 6 weeks for pyogenic spondylodiscitis. However, some durations seem incompressible and/or require individualization: 14 days for febrile male urinary tract infections, 12 weeks for infections on osteoarticular prostheses. It is necessary to reduce the duration of antibiotic treatment to the minimum necessary and to evaluate personalized durations taking into account, in particular, immunocompromised patients who are often excluded from trials.