Antimicrobial therapy optimal duration

The optimal duration of antimicrobial therapy for otitis media has not been established. Some studies have demonstrated efficacy with 3 to 5 days of therapy in acute uncomplicated otitis media. However, high-risk populations, e.g., children younger than 3 years of age and those with resistant or recurrent infections, were not studied. 

The optimal duration of therapy for febrile neutropenia is controversial. The decision to discontinue antimicrobials is based on resolution of neutropenia, defervescence, culture results, and clinical stability of the patient. 

A key controversy in the management of febrile neutropenia in cancer patients is the optimal time to stop empirical antimicrobial therapy in patients who remain persistently febrile. Patients individual risk of severe infection (determined by extent and duration of neutropenia, as well as other risk factors) helps to guide treatment decisions in this setting. 

The optimal duration of antimicrobial therapy of nosocomial pneumonia is not well established. Generally, a course for 10 to 21 days is recommended, the longer course would be reasonably indicated for those patients with extensive infection involving multiple lobes, highly resistant organisms such as Acineto-bacter and P. aeruginosa, cavitary disease, or malnutrition (16,45). Because the bioavailability of the quinolones when administered orally is equivalent... 

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