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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
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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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Peer review status:POSTED

23 Jun 2020Submitted to Journal of Evaluation in Clinical Practice
24 Jun 2020Assigned to Editor
24 Jun 2020Submission Checks Completed

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.