TOPLINE

A higher proportion of US adults preferred longer antibiotic courses of 7 days or more over shorter 3- to 5-day regimens for bacterial respiratory infections in a survey, and rated longer courses as safer and more effective.

METHODOLOGY

• Researchers conducted a cross-sectional online survey of 1475 US adults (mean age of 52.2 years; 50% women; 30.2% non-Hispanic White, 29.8% non-Hispanic Black, and 30% Hispanic adults) between March and April 2024 to assess beliefs about antibiotic durations and adherence for common bacterial respiratory infections.
• Participants were asked to indicate their preference between short (3-5 days) and long (≥7 days) antibiotic courses and to rate the safety and effectiveness of each duration.
• Multivariable logistic regression was used to identify characteristics associated with preferences for short vs long antibiotic durations, with all variables included simultaneously based on conceptual relevance.

TAKEAWAY

• A higher proportion of the respondents preferred longer antibiotic courses over shorter ones for treatment of bacterial respiratory infections (60.4% vs 39.5%; P <.001), and believed longer courses were safer (61.5%) and more effective (63%) than shorter courses (P <.001 for both).
• Most respondents (88.4%) believed that it is important to always finish a prescribed course of antibiotics even when feeling better, with 76.3% reporting they had received this advice from a medical professional, primarily physicians (75.1% of those advised).
• Respondents who preferred longer courses were significantly older, more trusting of their doctor's advice about antibiotic durations, more likely to have been told by a medical professional to always finish antibiotics, less worried about side effects, and less comfortable with being advised to stop antibiotics early.
• Only 17.5% of respondents reported ever being told to stop taking antibiotics when feeling better, yet 59.2% indicated they would feel at least somewhat comfortable with such advice from their clinician, and 57.4% would perceive the clinician as at least somewhat competent.

IN PRACTICE

These findings "highlight that many US adults' antibiotic beliefs and preferences conflict with evolving clinical perspectives on appropriate antibiotic durations, the applicability of the 'always finish antibiotics' mantra, and adherence plans for common bacterial infections," the authors wrote, adding the results "have important implications for clinicians and public health professionals aiming to inform patients about revised and updated guidance about the safety and preference for short duration therapy."

SOURCE

The study was led by Alistair Thorpe, PhD, Department of Population Health Sciences, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City. It was published online on July 21 in Open Forum Infectious Diseases.

LIMITATIONS

As a cross-sectional, online, English-only survey, results cannot be generalized to underrepresented groups and cannot capture change over time. Responses relied on self-reported attitudes and experiences subject to recall and social desirability biases. Binary response options could have influenced choices.

DISCLOSURES

The study was supported by internal research funds from the Departments of Population Health Sciences and Internal Medicine at the University of Utah and the Department of Medicine at the University of Alabama, and an award from the American Heart Association. The authors reported no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.