Antibiotic overuse significantly contributes to the growing issue of antimicrobial resistance (AMR), which poses a serious threat to global health. Researchers from the Yong Loo Lin School of Medicine at the National University of Singapore (NUS Medicine) and Duke-NUS Medical School have discovered that short-duration antibiotic therapies can effectively address ventilator-associated pneumonia (VAP), a critical infection prevalent among seriously ill patients.
Antibiotic overuse significantly contributes to the growing issue of antimicrobial resistance (AMR), which poses a serious threat to global health. Researchers from the Yong Loo Lin School of Medicine at the National University of Singapore (NUS Medicine) and Duke-NUS Medical School have discovered that short-duration antibiotic therapies can effectively address ventilator-associated pneumonia (VAP), a critical infection prevalent among seriously ill patients.
The results from the significant REGARD-VAP trial, featured in Lancet Respiratory Medicine, along with related economic studies published in Lancet Global Health, underscore how responsible antibiotic use can help fight resistance, protecting patients and addressing the worldwide challenge of antimicrobial resistance while also lowering healthcare expenses.
Conducted by the NUS Medicine research team, the clinical trial involved more than 450 patients from intensive care units (ICUs) in Singapore, Thailand, and Nepal. The findings indicated that short-term antibiotics—specifically tailored to each patient’s recovery—are as effective as longer courses in preventing pneumonia-related deaths and recurrences. “By decreasing the length of antibiotic treatment, we can lower the chances of side effects and resistance while still achieving positive patient outcomes,” remarked Dr. Mo Yin, a Junior Academic Fellow in the Department of Medicine at NUS Medicine, who led the clinical trial and co-authored the economic evaluation.
The economic studies, led by the Duke-NUS team, were just published in the journal Lancet Global Health. They showed that implementing short-course antibiotics is highly beneficial for healthcare systems. In Singapore, this approach is cost-effective, decreasing hospital costs while ensuring excellent patient outcomes. In Thailand and Nepal, short-course antibiotics were particularly cost-efficient, providing health benefits that outweighed the modest additional expenses. “Short-course antibiotics represent a practical solution that is advantageous for both patients and healthcare systems, especially in resource-constrained environments,” noted Assistant Professor Yiying Cai, the principal researcher from the Health Services and Systems Research Programme at Duke-NUS.
The insights from the REGARD-VAP study hold important implications for hospitals across the globe. These short-duration treatments can enhance infection management in ICUs, where effective treatment is crucial. This strategy works well in high-income (Singapore), middle-income (Thailand), and low-income (Nepal) countries, making it a versatile option for various healthcare environments. The findings provide strong evidence, including cost-effectiveness data, for policymakers considering the incorporation of short-course antibiotics in national and institutional healthcare guidelines.
The research team aims to share their results internationally to promote the use of short-course antibiotics, particularly in under-resourced regions. They also suggest that future clinical trials should include cost-effectiveness analyses to enrich clinical and economic decision-making. By minimizing unnecessary antibiotic use, these shorter treatments can help sustain the efficacy of existing medications for future generations. Each extra day of antibiotic use heightens the risk of drug resistance by 7%. Thus, shortening treatment lengths is a vital measure in addressing this silent crisis. “Thoughtful antibiotic utilization is crucial to combatting antimicrobial resistance and enhancing healthcare outcomes. Our findings strongly support the adoption of short-course antibiotics as the new standard of care,” added Dr. Mo Yin.
