Davar, Kusha; Clark, Devin; Centor, Robert M; Dominguez, Fernando; Ghanem, Bassam; Lee, Rachael; Lee, Todd C; McDonald, Emily G; Phillips, Matthew C; Sendi, Parham; Spellberg, Brad (2023). Can the Future of ID Escape the Inertial Dogma of Its Past? The Exemplars of Shorter Is Better and Oral Is the New IV. Open Forum Infectious Diseases, 10(1), ofac706. Oxford University Press 10.1093/ofid/ofac706
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Like all fields of medicine, Infectious Diseases is rife with dogma that underpins much clinical practice. In this study, we discuss 2 specific examples of historical practice that have been overturned recently by numerous prospective studies: traditional durations of antimicrobial therapy and the necessity of intravenous (IV)-only therapy for specific infectious syndromes. These dogmas are based on uncontrolled case series from >50 years ago, amplified by the opinions of eminent experts. In contrast, more than 120 modern, randomized controlled trials have established that shorter durations of therapy are equally effective for many infections. Furthermore, 21 concordant randomized controlled trials have demonstrated that oral antibiotic therapy is at least as effective as IV-only therapy for osteomyelitis, bacteremia, and endocarditis. Nevertheless, practitioners in many clinical settings remain refractory to adopting these changes. It is time for Infectious Diseases to move beyond its history of eminent opinion-based medicine and truly into the era of evidenced-based medicine.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Service Sector > Institute for Infectious Diseases |
UniBE Contributor: |
Sendi, Parham |
Subjects: |
500 Science > 570 Life sciences; biology 600 Technology > 610 Medicine & health |
ISSN: |
2328-8957 |
Publisher: |
Oxford University Press |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
26 Jan 2023 12:47 |
Last Modified: |
05 Feb 2023 02:25 |
Publisher DOI: |
10.1093/ofid/ofac706 |
PubMed ID: |
36694838 |
Uncontrolled Keywords: |
antibiotic dogma evidenced-based medicine oral antibiotics shorter is better |
BORIS DOI: |
10.48350/177909 |
URI: |
https://boris.unibe.ch/id/eprint/177909 |
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