Studies evaluating short-course
therapy have focused on prevalent
infections with demonstrable aetiology. Metaanalyses of clinical trials demonstrate that uncomplicated acute
otitis media in children can be successfully treated with a 5-day course of
cefuroxime axetil. In the treatment of tonsillopharyngitis, 4 - 5-day courses of oral
cephalosporins compared favourably with the standard 10-day
penicillin V regimen. The clinical cure rate and the bacteriological eradication rate were both significantly higher for
cephalosporins than for
penicillin V. Bacteriological failure rates for
cephalosporins were about half those for
penicillin. In studies on acute bacterial exacerbations of
chronic bronchitis, no difference in the clinical cure rates or relapse rates was found between short-course
therapy using
cephalosporins and standard courses. The short courses had the advantage of improved gastrointestinal tolerance compared with longer durations of treatment. The results suggest that new short-course dosing regimens are viable and may be favourable in terms of increased tolerability, reduction in healthcare costs, enhanced patient compliance and the control of the development of antibiotic resistance.