6/28/23, 1:21 AM Duration of antibiotics in community-acquired pneumonia Pathway Feedback Search Clinical Topics Home Studies Duration of antibiotics in community-acquired pneumonia Duration of antibiotics in community-acquired pneumonia Disease Community-acquired pneumonia Trial question What is the role of duration of antibiotic treatment in patients with community-acquired pneumonia? Study design Multi-center Open label RCT Population Characteristics of study participants 37.0% female N = 312 63.0% male 312 patients (116 female, 196 male) Inclusion criteria: hospitalized patients with community-acquired pneumonia (CAP) Key exclusion criteria: human immunodeficiency virus infection; chronic immunosuppression; lived in a nursing home; discharge from an acute care hospital, an onsite subacute care unit, or a palliative care unit within the previous 14 days; taken antibiotics in the 30 days before admission Interventions N=162 protocolized discontinuation of antibiotics after 5 days (duration of antibiotic treatment for a minimum of 5 days) N=150 physician-guided antibiotic discontinuation (duration of antibiotic treatment determined by physicians) https://web.pathway.md/studies/recfH6vvSTTI2Dig8 1/2 6/28/23, 1:21 AM Duration of antibiotics in community-acquired pneumonia Pathway Primary outcome Clinical success at day 10 56.3 % 56.3 48.6 42.2 % 28.1 % Difference not exceeding nonferiority margin 14.1 % 0.0 % Protocolized discontinuation of antibiotics after 5 days Physician-guided antibiotic discontinuation Difference not exceeding nonferiority margin in clinical success at day 10 (56.3% vs. 48.6%; RR 1.16, 95% CI -0.53 to 2.85) Secondary outcomes No significant difference in clinical success at day 30 (91.9% vs. 88.6%; RR 1.04, 95% CI -1.03 to 3.11) No significant difference in mean CAP symptom questionnaire scores at day 5 (27.2 vs. 24.7; AD 2.5, 95% CI -0.48 to 5.48) No significant difference in mean CAP symptom questionnaire scores at day 10 (17.9 vs. 18.6; AD -0.7, 95% CI -3.99 to 2.59) Conclusion In hospitalized patients with community-acquired pneumonia (CAP), protocolized discontinuation of antibiotics after 5 days were noninferior to physician-guided antibiotic discontinuation with respect to clinical success at day 10. Reference Uranga A, Espana PP, Bilbao A et al. Duration of Antibiotic Treatment in Community-Acquired Pneumonia: A Multicenter Randomized Clinical Trial. JAMA Intern Med. 2016 Sep 1;176(9):1257-65. Open reference URL https://web.pathway.md/studies/recfH6vvSTTI2Dig8 2/2