Shorter is better

Contrary to a lot of received previous recommendations, the shorter duration of antibiotics prescription and use (3-5) days is overall better than the prolonged use of durations between 7-14 days (JAMA Link).  A so-called narrative review of medical studies (Lee et al.2023) reports more precise results separate for medical indications (pneumonia, sinusitis etc.), which tend to go in the same direction for the majority of indications. In view of the serious issue of antimicrobial resistance, a consequence of overconsumption and too widespread use of antibiotics (also in animal health and food production), the slogan of shorter is better should receive serious attention.
It is not only a medical, pharmaceutical or public health issue. The topic has become an issue of nutrition as well. The food chain contains largely unknown amounts of antibiotics as well, especially if larger amounts of animal or fish products are part of it.
The knowledge from these sciences has still to filter through to the broader public. This means it has become a social science topic as well. The transmission of knowledge and patient expectations on prescriptions, which is also linked to regulations concerning sick leave, make it more difficult to shorten prescriptions of antibiotics. There is a steep challenge to change behaviour according to the new mantra “shorter is better” with respect to antibiotics, even if we know that it is better for all of us in the medium or long term.
(Image: Jan Harmensz. Muller, De keuze van de rechte levensweg 1571-1628, MRBAB, Brussels)