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

BMC Pulmonary Medicine

Jesus Camino MD¹  Julia Amaranta García MD²  Jose Luis Lobo MD²  Ignacio Arriaga MD³  Maider Intxausti MD³  Amaia Artaraz MD⁴  Pedro Pablo España MD⁴  Ane Uranga MD⁴  Jose María Quintana MD⁵  Amaia Bilbao MD⁶ 

[1] Department of Pneumology, Osakidetza, Hospital of San Eloy, Barakaldo, Bizkaia, Spain;Department of Pneumology, Osakidetza, Universitary Hospital of Alava, Vitoria, Alava, Spain;Department of Pneumology, Osakidetza, Universitary Hospital of Basurto, Bilbao, Bizkaia, Spain;Department of Pneumology, Osakidetza, Universitary Hospital of Galdakao-Usansolo, Barrio Labeaga s/n, 48960, Galdakao, Bizkaia, Spain;Health Services Research on Chronic Patients Network (REDISSEC), Galdakao, Bizkaia, Spain;Institute of Reasearch in Health Services Kronikgune, Barakaldo, Bizkaia, Spain;Research Unit, Osakidetza, Universitary Hospital of Galdakao-Usansolo, Galdakao, Bizkaia, Spain;Research Unit, Osakidetza, Universitary Hospital of Basurto, Bilbao, Bizkaia, Spain;Health Services Research on Chronic Patients Network (REDISSEC), Galdakao, Bizkaia, Spain;Institute of Reasearch in Health Services Kronikgune, Barakaldo, Bizkaia, Spain;

关键词: Pneumonia;    Duration;    Antibiotic;    Prognosis;    Complications;   

DOI  :  10.1186/s12890-020-01293-6

来源: Springer

【 摘 要 】

BackgroundThe 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.MethodsThis 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.ResultsA 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).ConclusionsReducing antibiotic treatment in hospitalized patients with CAP based on clinical stability criteria is safe, without leading to a greater number of long-term complications.

【 授权许可】

CC BY