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Impact of reducing the duration of antibiotic treatment on the long-term prognosis of community acquired pneumonia.
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  • Ane Uranga,
  • Amaia Artaraz,
  • Amaia Bilbao,
  • Jose M. Quintana,
  • Ignacio Arriaga,
  • Maider Intxausti,
  • Jose Luis Lobo,
  • Julia Amaranta García,
  • Jesus Camino,
  • Pedro Pablo España
Ane Uranga
Hospital Galdakao-Usansolo

Corresponding Author:ane.urangaecheverria@osakidetza.eus

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Amaia Artaraz
Hospital Galdakao-Usansolo
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Amaia Bilbao
Basurto University Hospital
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Jose M. Quintana
Hosp Galdakao Usansolo
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Ignacio Arriaga
Basurto University Hospital
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Maider Intxausti
Basurto University Hospital
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Jose Luis Lobo
Araba University Hospital
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Julia Amaranta García
Araba University Hospital
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Jesus Camino
Hospital San Eloy
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Pedro Pablo España
Hospital Galdakao-Usansolo
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Abstract

Rationale: 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 one 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 were 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. 90 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.
23 Jun 2020Submitted to Journal of Evaluation in Clinical Practice
24 Jun 2020Submission Checks Completed
24 Jun 2020Assigned to Editor
Dec 2020Published in BMC Pulmonary Medicine volume 20 issue 1. 10.1186/s12890-020-01293-6