What is the difference between a short interval and a long interval?

From the Guidelines

For the treatment duration, I recommend a short-term duration of four weeks or less, as defined by the European Position Paper on Rhinosinusitis and Nasal Polyps 2020 1. This definition is based on the agreement by the EPO2020 steering group that four weeks or less would be considered 'short-term', with the aim of short-term treatment being different from long-term treatment. The short-term treatment is generally given for acute bacterial infection, whereas long-term courses are given for their immunomodulatory properties. Some studies suggest that the INR recall interval may vary depending on the patient's condition and the etiology of the out-of-range INR 1. However, these studies are not directly related to the treatment duration of rhinosinusitis and nasal polyps, and therefore, I prioritize the European Position Paper on Rhinosinusitis and Nasal Polyps 2020 1 for this recommendation. Key points to consider when determining the treatment duration include:

• The aim of the treatment: short-term treatment for acute bacterial infection or long-term treatment for immunomodulatory properties
• The patient's condition: stable or unstable, with or without complications
• The etiology of the out-of-range INR: if applicable It is essential to note that the treatment duration may vary depending on the individual patient's needs and response to treatment. Regular follow-up and monitoring are crucial to ensure the best possible outcome and adjust the treatment plan as needed.

From the Research

Antibiotic Treatment Duration

• The duration of antibiotic treatment is often unnecessarily long due to clinician fear of clinical relapse 2
• Recent randomized controlled trials have demonstrated noninferiority of short-course therapy for common infections such as community acquired pneumonia, intraabdominal sepsis, gram-negative bacteraemia, and vertebral osteomyelitis 2
• High-quality evidence supports shorter treatment durations, which can help clinicians change prescribing habits and reduce antibiotic overuse 2

Contextual Errors in Medical Decision Making

• Contextual errors occur when clinicians fail to consider individual patient circumstances and needs, leading to inappropriate treatment decisions 3
• These errors can have significant implications for quality of care and patient outcomes 3
• Strategies for measuring clinician attention to patient context and reducing contextual errors are being developed 3

Vaccination and Antibiotic Use

• Influenza vaccination has been shown to reduce antibiotic use, with a stronger effect compared to pneumococcal vaccination 4
• The impact of vaccination on antibiotic use varies by region and study design, with most studies conducted in high-income countries 4
• Reducing antibiotic use through vaccination can help control antimicrobial resistance 4

Medical Errors and Communication

• Communication about medical errors is essential for maintaining trust and promoting patient safety 5
• Healthcare professionals should be honest, reflective, compassionate, and courageous when discussing errors with patients and families 5
• A systems approach to patient safety and a culture of transparency and learning can support healthcare professionals in coping with errors and improving care 5