• Antibiotics are prescribed in >60% of adults with acute rhinosinusitis, acute bronchitis or sore throat
• Inappropriate antibiotic use has negative implications, like the risk of subsequent infection with resistant organisms, Clostridioides difficile infections as well as adverse events
• Completion of antibiotic treatment after initiation is classically postulated. 

Objectives-

To assess the advantages/disadvantages of discontinuing unnecessary antibiotic therapy, when antibiotics are no longer considered necessary for uncomplicated respiratory tract infections (RTI).

Design-

Multicenter, open-label, randomized controlled clinical trial was conducted from 2017 to 2020. 

It enrolled adults with RTIs – acute rhinosinusitis, sore throat, influenza, or acute bronchitis – who had previously taken any dose of antibiotic for <3 days, which physicians no longer considered necessary.

The patients were randomized at 1:1 to -

• Discontinuing antibiotic therapy 
• Continuing antibiotic treatment. 

Main Outcomes

The primary outcome assessed the duration of severe symptoms (number of days scoring 5 or 6 on a 6-item Likert scale). 

Secondary outcomes assessed days with symptoms, moderate symptoms (scores of 3 or 4), antibiotics taken, adverse events, patient satisfaction, and complications within the first 3 months.

Results-

Conclusions

Its safe to discontinue antibiotic treatment for uncomplicated RTIs when clinicians consider it unnecessary. Additionally, it reduces antibiotic consumption.

Reference-

Llor C, Moragas A, Bayona C, Cots JM, Hernández S, Calviño O, Rodríguez M, Miravitlles M. Efficacy and safety of discontinuing antibiotic treatment for uncomplicated respiratory tract infections when deemed unnecessary. A multicentre, randomised clinical trial in primary care.

Clin Microbiol Infect. 2021 Aug 4;S1198-743X(21)00430-4.