"Give Me Five": The Case for 5 Days of Antibiotics as the Default Duration for Acute Respiratory Tract Infections.

This article focuses on the duration of antibiotic therapy for common pediatric acute respiratory tract infections (ARTIs), specifically group A streptococcal (GAS) pharyngitis, acute otitis media (AOM), and acute bacterial rhinosinusitis (ABRS). It highlights that despite longstanding US guidelines recommending 10-day antibiotic courses, emerging evidence supports that shorter courses of around 5 days are safe and effective for most uncomplicated cases, with minimal risk of complications. The article discusses the influence of "academic imprinting," or adherence to traditional practices despite limited supporting evidence, and compares US recommendations with shorter durations endorsed internationally. It also addresses issues such as antibiotic adherence, overprescribing, drug shortages, and the importance of antimicrobial stewardship in reducing unnecessary antibiotic exposure in children.