Amoxicillin for CAP—three days, or longer?BMJ 2006; 332 doi: https://doi.org/10.1136/bmj.332.7554.0-a (Published 08 June 2006) Cite this as: BMJ 2006;332:0-a
All rapid responses
In any infectious disease, hit the pathogen hard and eliminate it
quickly. Use the antibiotic for the shortest possible period. These appear
to be commanding principles.
However treatment is not always simple and straight forward.
Decisions have to be made on the basis of experience, reason and a clear
understanding of the processes involved which are unravelled on a daily
basis by the advances in science.
The treatment of community acquired pneumonia by a three day course
of antibiotics is a most welcome contribution to medical practice. The
advantages of rapid recovery, a short stay in hospital, and a short course
of antibiotics are obvious. Above all it would hamper the development and
dissemination of resistant organisms.
Short appropriate and effectve treatments have so much to commend. In
every infection the pathogen has to compete for survival against the
patient's immune mechanisms which play a central role in eliminating the
disease. Antibiotics are wonder drugs; when correctly used they upset the
balance in favour of the patient and help the body to get rid of the
infection quickly and effectively.
Understanding the patient, the pathogen and the antibiotic
provides for medical proficiency.
I can cite several examples: Two doses of 2 gram cephalexin for
treating cystitis in women, single dose fluoroquinolnes for treating a
multitude of infectious diseases by illiterate people in India. Please
forgive my blasphemy.
When patients are otherwise healthy and have a good immune system the
design and use of short swift courses can be sound medical practice.
Competing interests: No competing interests