SINGAPORE: Antibiotic overuse is a leading contributor to the global health crisis of antimicrobial resistance (AMR), a growing threat to modern medicine. However, research conducted by the Yong Loo Lin School of Medicine at the National University of Singapore (NUS Medicine) and Duke-NUS Medical School provides new hope in the fight against this crisis.
Their findings, recently published in Lancet Respiratory Medicine and Lancet Global Health, reveal that short-course antibiotic treatments can effectively tackle ventilator-associated pneumonia (VAP) while curbing the spread of AMR.
The pivotal REGARD-VAP trial, led by researchers from NUS Medicine, studied over 450 patients in intensive care units (ICUs) across Singapore, Thailand, and Nepal. It demonstrated that short-course antibiotics tailored to individual recovery are just as effective as traditional longer treatments in preventing death and the recurrence of pneumonia.
This innovative approach significantly reduces the risks of side effects and antibiotic resistance without compromising patient outcomes.
“By shortening the duration of antibiotics, we can reduce the risks of side effects and resistance without compromising patient outcomes,” explained Dr Mo Yin, Junior Academic Fellow at the Department of Medicine, NUS Medicine, and principal investigator of the trial.
An accompanying economic analysis conducted by Duke-NUS researchers highlighted the value of this approach for healthcare systems. In Singapore, short-course antibiotics reduced hospital costs while maintaining excellent patient outcomes. In Thailand and Nepal, the strategy was highly cost-effective, with health benefits outweighing modest additional expenses.
“Short-course antibiotics are a pragmatic solution that benefits patients and healthcare systems alike, particularly in resource-limited settings,” said Assistant Professor Yiying Cai from Duke-NUS’s Health Services and Systems Research Programme.
The REGARD-VAP study’s findings have broad implications for hospitals worldwide. By streamlining treatment in ICUs, short-course antibiotics offer a scalable solution for high-, middle-, and low-income settings alike. These results provide compelling evidence for policymakers to incorporate short-course treatments into national and institutional guidelines.
Every additional day of antibiotic use increases the risk of developing drug resistance by 7%. Shortening treatment durations is a critical step in preserving the effectiveness of existing antibiotics. By reducing unnecessary exposure, this strategy helps ensure these life-saving drugs remain effective for future generations.
The researchers are now advocating for global adoption of their findings, particularly in resource-limited regions, and urge the integration of cost-effectiveness analyses into future clinical trials to enhance both clinical and economic decision-making.
“Prudent antibiotic use is essential to combat antimicrobial resistance and optimise healthcare outcomes,” concluded Dr Mo Yin. “Our findings make a strong case for adopting short-course antibiotics as the new standard of care.”
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