Study: Only 60% of immunocompromised patients improve serology after RSV vaccination

observation study A study of community-dwelling older adults in Canada found that long-term antibiotic use was not associated with a greater risk of harm than short-term use, researchers reported today. Clinical infections.

Researchers at the University of Toronto used province-wide administrative health data to find that Ontario residents who received short-term (3-7 days) or long-term (8-14 days) prescriptions for amoxicillin, ciprofloxacin, and cephalexin assessed harm in 117,682 outpatients aged 66 to 110 years. The main outcomes were side effects, clostridioides difficile infections, antibiotic resistance, etc. Secondary outcomes were a composite of safety measures, including repeat antibiotic prescriptions, hospital visits, and mortality.

To reduce the risk of bias, the researchers used an instrumental variable analysis that took into account prescribers' preferences for choosing longer time periods.

“Given the high variability among prescribers independent of patient population, physicians' propensity to prescribe for long periods of time may be an important instrumental variable,” the study authors wrote.

No increased risk of harm or safety

Primary and secondary outcomes were similar among patients receiving long-term prescriptions from low, intermediate, and high prescribers for all three antibiotics evaluated. After adjusting for patient- and prescriber-level variables, longer courses were not associated with higher odds of experiencing antibiotic-related harms to amoxicillin (odds ratio) [OR]0.99; 95% confidence interval [CI]0.84 to 1.15), cephalexin (OR, 1.11; 95% CI, 0.90 to 1.38), or ciprofloxacin (OR, 0.94; 95% CI, 0.74 to 1.20). Safety results were similar (amoxicillin OR, 1.01; 95%CI, 0.94 to 1.08; cephalexin OR, 1.06; 95%CI, 0.97 to 1.17; ciprofloxacin OR, 0.99; 95%CI, 0.85 to 1.15 ).

Several previous studies have found that the longer antibiotics are given, the greater the risk of patient harm, but the authors note that these studies were primarily conducted in hospital settings. The researchers note that patients may be more susceptible to antibiotic-related harms depending on their age and severity of illness. , and the presence of comorbidities.

“These findings may suggest that community-dwelling patients are at lower risk of harm. and “While there is a benefit from antibiotic therapy, the effect of duration may be negligible,” the researchers wrote.

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