Impact of reducing the duration of antibiotic treatment on the long-term prognosis of community acquired pneumonia

• Published in: BMC pulmonary medicine Vol. 20; no. 1; p. 261
• Main Authors: Uranga, Ane, Artaraz, Amaia, Bilbao, Amaia, Quintana, Jose María, Arriaga, Ignacio, Intxausti, Maider, Lobo, Jose Luis, García, Julia Amaranta, Camino, Jesus, España, Pedro Pablo
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 07-10-2020; BioMed Central; BMC
• Subjects: Adrenomedullin; Antibiotic; Antibiotics; Biomarkers; C-reactive protein; Cardiovascular disease; Clinical trials; Community-acquired infections; Comorbidity; Complications; Dosage and administration; Drug therapy; Duration; Methods; Mortality; Patient outcomes; Patients; Pneumonia; Procalcitonin; Prognosis; Pulmonology; Streptococcus infections; Variables; Spain; Antibiotic; Pneumonia; Duration; Prognosis; Complications
• ISSN: 1471-2466; 1471-2466
• DOI: 10.1186/s12890-020-01293-6

The optimal duration of antibiotic treatment for community-acquired pneumonia (CAP) is not well established. The aim of this study was to assess the impact of reducing the duration of antibiotic treatment on long-term prognosis in patients hospitalized with CAP.
This was a multicenter study assessing complications developed during 1 year of patients previously hospitalized with CAP who had been included in a randomized clinical trial concerning the duration of antibiotic treatment. Mortality at 90 days, at 180 days and at 1 year was analyzed, as well as new admissions and cardiovascular complications. A subanalysis was carried out in one of the hospitals by measuring C-reactive protein (CRP), procalcitonin (PCT) and proadrenomedullin (proADM) at admission, at day 5 and at day 30.
A total of 312 patients were included, 150 in the control group and 162 in the intervention group. Ninety day, 180 day and 1-year mortality in the per-protocol analysis were 8 (2.57%), 10 (3.22%) and 14 (4.50%), respectively. There were no significant differences between both groups in terms of 1-year mortality (p = 0.94), new admissions (p = 0.84) or cardiovascular events (p = 0.33). No differences were observed between biomarker level differences from day 5 to day 30 (CRP p = 0.29; PCT p = 0.44; proADM p = 0.52).
Reducing antibiotic treatment in hospitalized patients with CAP based on clinical stability criteria is safe, without leading to a greater number of long-term complications.