Shifting the mindset regarding adherence to antibiotic use for respiratory tract infections

Some papers emphasize adherence to antibiotic therapy, but a paradigm shift is needed. While nonadherence may impact chronic conditions, it has not been proven to affect community respiratory tract infections outside of tuberculosis. Respiratory infections, which account for most community antibioti...

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Main Author: Carl Llor
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Exploratory Research in Clinical and Social Pharmacy
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Online Access:http://www.sciencedirect.com/science/article/pii/S2667276625000290
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author Carl Llor
author_facet Carl Llor
author_sort Carl Llor
collection DOAJ
description Some papers emphasize adherence to antibiotic therapy, but a paradigm shift is needed. While nonadherence may impact chronic conditions, it has not been proven to affect community respiratory tract infections outside of tuberculosis. Respiratory infections, which account for most community antibiotic prescriptions, often involve inappropriate antibiotic use, even in developed countries, with up to 80 % of consultations resulting in prescriptions. Over-the-counter sales of antibiotics further exacerbate this issue. Research should explore whether stopping antibiotics after symptom resolution, rather than completing the full course, is feasible for non-severe infections. Shorter antibiotic courses have shown similar effectiveness with fewer side effects, aligning with the “shorter is better” principle. The idea that completing the entire antibiotic course prevents antimicrobial resistance remains unproven. Instead, longer exposure to antibiotics increases resistance. A patient-centered approach, focusing on outcomes, is essential for the future of antibiotic stewardship.
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spelling doaj-art-9bd2706aec204d9182fde7355e7dc65a2025-08-20T02:31:56ZengElsevierExploratory Research in Clinical and Social Pharmacy2667-27662025-06-011810058810.1016/j.rcsop.2025.100588Shifting the mindset regarding adherence to antibiotic use for respiratory tract infectionsCarl Llor0Primary Care Research Institute Jordi Gol (IDIAP), Barcelona, Spain; CIBER Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain; Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense-Esbjerg, Denmark; Corresponding author at: Department of Public Health, General Practice, University of Southern Denmark, Campusvej, 55, DK-5230 Odense, Denmark.Some papers emphasize adherence to antibiotic therapy, but a paradigm shift is needed. While nonadherence may impact chronic conditions, it has not been proven to affect community respiratory tract infections outside of tuberculosis. Respiratory infections, which account for most community antibiotic prescriptions, often involve inappropriate antibiotic use, even in developed countries, with up to 80 % of consultations resulting in prescriptions. Over-the-counter sales of antibiotics further exacerbate this issue. Research should explore whether stopping antibiotics after symptom resolution, rather than completing the full course, is feasible for non-severe infections. Shorter antibiotic courses have shown similar effectiveness with fewer side effects, aligning with the “shorter is better” principle. The idea that completing the entire antibiotic course prevents antimicrobial resistance remains unproven. Instead, longer exposure to antibiotics increases resistance. A patient-centered approach, focusing on outcomes, is essential for the future of antibiotic stewardship.http://www.sciencedirect.com/science/article/pii/S2667276625000290Medication adherenceAnti-bacterial agentsRespiratory tract infectionsPatient-centered care-
spellingShingle Carl Llor
Shifting the mindset regarding adherence to antibiotic use for respiratory tract infections
Exploratory Research in Clinical and Social Pharmacy
Medication adherence
Anti-bacterial agents
Respiratory tract infections
Patient-centered care-
title Shifting the mindset regarding adherence to antibiotic use for respiratory tract infections
title_full Shifting the mindset regarding adherence to antibiotic use for respiratory tract infections
title_fullStr Shifting the mindset regarding adherence to antibiotic use for respiratory tract infections
title_full_unstemmed Shifting the mindset regarding adherence to antibiotic use for respiratory tract infections
title_short Shifting the mindset regarding adherence to antibiotic use for respiratory tract infections
title_sort shifting the mindset regarding adherence to antibiotic use for respiratory tract infections
topic Medication adherence
Anti-bacterial agents
Respiratory tract infections
Patient-centered care-
url http://www.sciencedirect.com/science/article/pii/S2667276625000290
work_keys_str_mv AT carlllor shiftingthemindsetregardingadherencetoantibioticuseforrespiratorytractinfections