Abstract
International experts suggest tailoring antibiotic duration in community-acquired pneumonia (CAP) according to patients' characteristics. We aimed to assess the effectiveness of an individualized approach to antibiotic duration based on time in which CAP patients reach clinical stability during hospitalization. In a multicenter, non-inferiority, randomized, controlled trial hospitalized adult patients with CAP reaching clinical stability within 5 days after hospitalization were randomized to a standard vs. individualized antibiotic duration. In the Individualized group, antibiotics were discontinued 48 h after the patient reached clinical stability, with at least five days of total antibiotic treatment. Early failure within 30 days was the primary composite outcome. 135 patients were randomized to the Standard group and 125 to the Individualized group. The trial was interrupted by the safety committee because of an apparent inferiority of the Individualized group over the Standard treatment: 14 (11.2%) patients in the Individualized group experienced early failure vs. 10 (7.4%) patients in the Standard group, p = 0.200, at the intention-to-treat analysis. 30-day mortality rate was four-time higher in the Individualized group than the Standard group. Shortening antibiotic duration according to patients' characteristics still remains an open question.
| Original language | English |
|---|---|
| Pages (from-to) | 191-201 |
| Number of pages | 11 |
| Journal | Pulmonary Pharmacology and Therapeutics |
| Volume | 45 |
| DOIs | |
| Publication status | Published - Aug 1 2017 |
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ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
- Biochemistry, medical
- Pharmacology (medical)
Cite this
Individualizing duration of antibiotic therapy in community-acquired pneumonia. / Aliberti, Stefano; Ramirez, Julio; Giuliani, Fabio; Wiemken, Timothy; Sotgiu, Giovanni; Tedeschi, Sara; Carugati, Manuela; Valenti, Vincenzo; Marchioni, Marco; Camera, Marco; Piro, Roberto; Del Forno, Manuela; Milani, Giuseppe; Faverio, Paola; Richeldi, Luca; Deotto, Martina; Villani, Massimiliano; Voza, Antonio; Tobaldini, Eleonora; Bernardi, Mauro; Bellone, Andrea; Bassetti, Matteo; Blasi, Francesco.
In: Pulmonary Pharmacology and Therapeutics, Vol. 45, 01.08.2017, p. 191-201.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Individualizing duration of antibiotic therapy in community-acquired pneumonia
AU - Aliberti, Stefano
AU - Ramirez, Julio
AU - Giuliani, Fabio
AU - Wiemken, Timothy
AU - Sotgiu, Giovanni
AU - Tedeschi, Sara
AU - Carugati, Manuela
AU - Valenti, Vincenzo
AU - Marchioni, Marco
AU - Camera, Marco
AU - Piro, Roberto
AU - Del Forno, Manuela
AU - Milani, Giuseppe
AU - Faverio, Paola
AU - Richeldi, Luca
AU - Deotto, Martina
AU - Villani, Massimiliano
AU - Voza, Antonio
AU - Tobaldini, Eleonora
AU - Bernardi, Mauro
AU - Bellone, Andrea
AU - Bassetti, Matteo
AU - Blasi, Francesco
PY - 2017/8/1
Y1 - 2017/8/1
N2 - International experts suggest tailoring antibiotic duration in community-acquired pneumonia (CAP) according to patients' characteristics. We aimed to assess the effectiveness of an individualized approach to antibiotic duration based on time in which CAP patients reach clinical stability during hospitalization. In a multicenter, non-inferiority, randomized, controlled trial hospitalized adult patients with CAP reaching clinical stability within 5 days after hospitalization were randomized to a standard vs. individualized antibiotic duration. In the Individualized group, antibiotics were discontinued 48 h after the patient reached clinical stability, with at least five days of total antibiotic treatment. Early failure within 30 days was the primary composite outcome. 135 patients were randomized to the Standard group and 125 to the Individualized group. The trial was interrupted by the safety committee because of an apparent inferiority of the Individualized group over the Standard treatment: 14 (11.2%) patients in the Individualized group experienced early failure vs. 10 (7.4%) patients in the Standard group, p = 0.200, at the intention-to-treat analysis. 30-day mortality rate was four-time higher in the Individualized group than the Standard group. Shortening antibiotic duration according to patients' characteristics still remains an open question.
AB - International experts suggest tailoring antibiotic duration in community-acquired pneumonia (CAP) according to patients' characteristics. We aimed to assess the effectiveness of an individualized approach to antibiotic duration based on time in which CAP patients reach clinical stability during hospitalization. In a multicenter, non-inferiority, randomized, controlled trial hospitalized adult patients with CAP reaching clinical stability within 5 days after hospitalization were randomized to a standard vs. individualized antibiotic duration. In the Individualized group, antibiotics were discontinued 48 h after the patient reached clinical stability, with at least five days of total antibiotic treatment. Early failure within 30 days was the primary composite outcome. 135 patients were randomized to the Standard group and 125 to the Individualized group. The trial was interrupted by the safety committee because of an apparent inferiority of the Individualized group over the Standard treatment: 14 (11.2%) patients in the Individualized group experienced early failure vs. 10 (7.4%) patients in the Standard group, p = 0.200, at the intention-to-treat analysis. 30-day mortality rate was four-time higher in the Individualized group than the Standard group. Shortening antibiotic duration according to patients' characteristics still remains an open question.
UR - http://www.scopus.com/inward/record.url?scp=85022174684&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85022174684&partnerID=8YFLogxK
U2 - 10.1016/j.pupt.2017.06.008
DO - 10.1016/j.pupt.2017.06.008
M3 - Article
AN - SCOPUS:85022174684
VL - 45
SP - 191
EP - 201
JO - Pulmonary Pharmacology and Therapeutics
JF - Pulmonary Pharmacology and Therapeutics
SN - 1094-5539
ER -