Appropriate Use of Short-Course Antibiotics in Common Infections

Publication Date: April 6, 2021
Last Updated: March 14, 2022

Best Practice Advice

Best Practice Advice 1:

Clinicians should limit antibiotic treatment duration to 5 days when managing patients with COPD exacerbations and acute uncomplicated bronchitis who have clinical signs of a bacterial infection (presence of increased sputum purulence in addition to increased dyspnea, and/or increased sputum volume).

Best Practice Advice 2:

Clinicians should prescribe antibiotics for community-acquired pneumonia for a minimum of 5 days. Extension of therapy after 5 days of antibiotics should be guided by validated measures of clinical stability, which include resolution of vital sign abnormalities, ability to eat, and normal mentation.

Best Practice Advice 3:

In women with uncomplicated bacterial cystitis, clinicians should prescribe short-course antibiotics with either nitrofurantoin for 5 days, trimethoprim–sulfamethoxazole (TMP–SMZ) for 3 days, or fosfomycin as a single dose. In men and women with uncomplicated pyelonephritis, clinicians should prescribe short-course therapy either with fluoroquinolones (5 to 7 days) or TMP–SMZ (14 days) based on antibiotic susceptibility.

Best Practice Advice 4:

In patients with nonpurulent cellulitis, clinicians should use a 5- to 6-day course of antibiotics active against streptococci, particularly for patients able to self-monitor and who have close follow-up with primary care.


Recommendation Grading




Appropriate Use of Short-Course Antibiotics in Common Infections

Authoring Organization

Publication Month/Year

April 6, 2021

Last Updated Month/Year

July 12, 2023

Supplemental Implementation Tools

Document Type


External Publication Status


Country of Publication


Inclusion Criteria

Female, Male, Adult, Older adult

Health Care Settings

Ambulatory, Emergency care, Hospital

Intended Users

Physician, nurse, nurse practitioner, physician assistant



Diseases/Conditions (MeSH)

D017714 - Community-Acquired Infections


community-acquired pneumonia, urinary tract infection (UTI), chronic obstructive pulmonary disease (COPD), antimicrobial, Short-Course Antibiotics, Common Infections, acute bronchitis, Cellutitis