Avoid antibiotics for low-grade fever, says ICMR

NEW DELHI: The Indian Council of Medical Research has issued guidelines warning against the use of antibiotics for conditions such as low-grade fever and viral bronchitis while advising doctors to follow a timeline while prescribing them.

The ICMR guidelines stated that antibiotics should be prescribed for five days for skin and soft tissue infections, five days in case of community-acquired pneumonia and eight days for hospital-acquired pneumonia.

“A clinical diagnosis most often helps us predict causative pathogens fitting into a clinical syndrome which would tailor the correct antibiotic rather than blindly relying on fever, procalcitonin levels, WBC counts, cultures or radiology to make a diagnosis of infection,” the guidelines said.

It stated limiting empiric antibiotic therapy to seriously ill.

Generally, empiric antibiotic therapy is only recommended for a select group of patients suffering from severe sepsis and septic shock, community-acquired pneumonia, ventilator-associated pneumonia and necrotizing fasciitis.

Hence, it is important to start smart and then focus, i.e., evaluate if empiric therapy can be justified or de-escalated and then make a plan about the duration of therapy, the guidelines said.

An ICMR survey last year had suggested that a big chunk of patients may no longer benefit from the use of carbapenem, antibiotic for pneumonia, septicemia, etc.