BMC Pulmonary Medicine (Oct 2020)

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

  • Ane Uranga MD,
  • Amaia Artaraz MD,
  • Amaia Bilbao MD,
  • Jose María Quintana MD,
  • Ignacio Arriaga MD,
  • Maider Intxausti MD,
  • Jose Luis Lobo MD,
  • Julia Amaranta García MD,
  • Jesus Camino MD,
  • Pedro Pablo España MD

DOI
https://doi.org/10.1186/s12890-020-01293-6
Journal volume & issue
Vol. 20, no. 1
pp. 1 – 8

Abstract

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Abstract Background 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. Methods 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. Results 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). Conclusions 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.

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