Short-term antibiotics can be a game changer

Short-term antibiotics can be a game changer

Antibiotic overuse is a key driver of the rise in antimicrobial resistance (AMR), a major global health crisis. Researchers from Yong Loo Lin School of Medicine, National University of Singapore (NUS Medicine) and Duke-NUS Medical School have provided compelling evidence that short-course antibiotic treatments can be a game-changer in combating ventilator-associated pneumonia (VAP), a serious infection in critically ill patients.

The results of Mahlmark Assist-VAP published in the Lancet Respiratory Medicine reduced healthcare costs.

Led by the NUS Medicine research team, the clinical trial examined over 450 patients in intensive care units (ICUS) in Singapore, Thailand and Nepal. The results showed that short-term antibiotics tailored to each patient's recovery were just as effective as traditional longer treatments in preventing death and recurrence of pneumonia. “By shortening the duration of antibiotics, we can reduce the risks of side effects and resistance without compromising patient outcomes” Co-author of the economic analysis.

The economic analyzes led by the Duke-NUS research team have just been published in the prestigious journal Lancet Global Health. They showed that short-haul antibiotic introduction provides significant value to health systems. In Singapore, the strategy is cost-saving and reduces hospital spending while maintaining excellent patient outcomes. In Thailand and Nepal, short-course antibiotics have been very cost-effective, with health gains outweighing the modest additional costs.

Short-course antibiotics are a pragmatic solution that benefits patients and healthcare systems alike, particularly in resource-limited settings. “

Assistant Professor Yiying CAI, principal investigator of the healthcare and systems research program at Duke-Nus

The results of the Respect VAP study have practical implications for hospitals worldwide. Short-term antibiotics can streamline treatment in the intensive care unit, where efficient treatment of infections is critical. The approach is effective in high-income (Singapore), middle-income (Thailand), and low-income (Nepal) settings, making it a scalable solution for diverse healthcare systems. These results provide robust evidence, including cost-effectiveness data, for policymakers to incorporate short-course antibiotics into national and institutional policies.

The team hopes to disseminate their findings globally to promote adoption of short-course antibiotics, particularly in resource-limited regions. They are also committed to integrating cost-effectiveness studies into future clinical trials to strengthen both clinical and economic decision-making processes. By reducing unnecessary exposure to antibiotics, short-course treatments help preserve the effectiveness of existing medicines for future generations. Each additional day of antibiotic use increases the risk of drug resistance by 7%. Reducing treatment duration is a critical step in combating this silent epidemic. "The cautious use of antibiotics is essential for combating antimicrobial resistance and optimizing health care. Our results provide a strong argument for the introduction of short-course antibiotics as a new standard of care," concluded Dr. Mo Yin.

The Aspect VAP study was supported by the UK Medical Research Council, the Wellcome Trust and National Research Foundation, Singapore, under the Central Gap Fund (Award ID: CTGIIT18MAY0005). The study, which combines clinical and economic data, sets a new benchmark for studies evaluating healthcare interventions.

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