Choosing the duration of antimicrobial therapy

Advice on duration is included in the clinical topics in these guidelines. The duration of therapy for some indications is based on clinical practice and experience because it is not clearly defined from published studies. In general, use the shortest possible duration of therapy, taking into consideration the condition being treated and the patient’s clinical response.

Where adequate source control has occurred, the total duration of antimicrobial therapy should include the days of empiric therapy where empiric therapy has adequate spectrum.

Prolonged duration of antimicrobial therapy is associated with direct and indirect adverse effects as well as increased costs.

Some examples of indications for which evidence supports a shorter duration of therapy (less than 7 days) are shown in Examples of indications for which shorter course therapy (less than 7 days) is often appropriate. However, there are certain indications that require prolonged therapy (eg endocarditis, osteomyelitis, Staphylococcus aureus bacteraemia).