Short-course antibiotic therapy for hospitalized patients with early clinical response in community-acquired pneumonia: a multicentre cohort study

Simone Bastrup Israelsen*, Markus Fally, Britta Tarp, Lilian Kolte, Pernille Ravn, Thomas Benfield

*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

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Abstract

Objectives: To explore whether short-course antibiotic therapy is efficient and safe in routine clinical settings among patients hospitalized with community-acquired pneumonia (CAP) who achieve an early clinical response. Methods: During 2017–2019, we conducted a cohort study of patients admitted with CAP to four hospitals in Denmark. Data were prospectively gathered from medical records and enriched with data from nationwide registries. In the present study, we included patients with early clinical response and divided them into treatment groups based on antibiotic duration, as decided by the attending physician: short-course (4–7 days) or prolonged-course (8–14 days). The primary outcome was post-treatment mortality within 30 days. Secondary outcomes included readmissions or new antibiotics. Logistic regression models were used to estimate ORs with 95% CIs, and inverse probability weighting was applied to adjust for confounding. Results: The study cohort included 1151 patients with a median age of 74 years, predominantly presenting with mild-moderate disease. The 30-day post-treatment mortality was 3.36% (11/327) in the short-course group and 3.40% (28/824) in the prolonged-course group (adjusted OR 1.05, 95% CI 0.38–1.88). Readmission occurred in 15.6% (42/269) vs. 14.0% (102/727) (adjusted OR 1.07, 95% CI 0.75–1.69) and new prescription of antibiotics in 11.9% (32/269) vs. 12.1% (88/727) (adjusted OR 0.99, 95% CI 0.61–1.49). Discussion: In patients hospitalized with CAP and early clinical response, similar outcomes were observed between short-course and prolonged-course therapies. These results support the use of short-course therapy in routine clinical settings.

OriginalsprogEngelsk
TidsskriftClinical Microbiology and Infection
Vol/bind29
Udgave nummer1
Sider (fra-til)54-60
Antal sider7
ISSN1198-743X
DOI
StatusUdgivet - 2023

Bibliografisk note

Funding Information:
T.B. reports grants from Novo Nordisk Foundation, Simonsen Foundation, Lundbeck Foundation, Kai Foundation, Erik and Susanna Olesen's Charitable Fund and MSD; grants and personal fees from GSK, Pfizer and Gilead Sciences; personal fees from Boehringer Ingelheim, AbbVie and Astra Zeneca, with no relation to the work reported in this paper. S.B.I., M.F., B.T., L.K., and P.R. declare that they have no conflict of interest. The study was funded by a grant from the Danish Ministry of Health (grant ID 1608969) and by the involved hospitals. The funders had no role in the design of the study, data collection, analyses, writing of the manuscript, or decision to publish the results.

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