Short-course antibiotic therapy for hospitalized patients with early clinical response in community-acquired pneumonia: a multicentre cohort study
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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.
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Abbreviated β-lactam courses (typically 3-5 days) can achieve comparable cure rates to longer regimens while reducing microbiome disruption and minimizing adverse effects.
“Evidence from controlled trials and real-world data consistently demonstrates that abbreviated β-lactam courses (typically 3-5 days) can achieve comparable cure rates to longer regimens while reducing microbiome disruption and minimizing adverse effects [16-18].”
From Clinical Outcomes and Real-World Effectiveness of Amoxicillin-Clavulanic Acid Across Indian Healthcare Settings: A Retrospective Multicenter Study (2026) · cites this paper as [18]
The Summary of results (page unavailable) reports comparable outcomes for the cohort’s 4–7-day versus 8–14-day courses and cites a trial finding that 3 days of β-lactams was noninferior to 8 days in clinically stable patients. The cohort did not test a typical 3–5-day β-lactam course, and the paper does not establish reduced microbiome disruption or fewer adverse effects. (LLM, conf=0.88)
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Raju, A., Kakar, A., Bhagat, D. K., Behera, S. K., Pathak, R., & Pal, S. (2026) · Cureus · doi:10.7759/cureus.104282
“Evidence from controlled trials and real-world data consistently demonstrates that abbreviated β -lactam courses (typically 3-5 days) can achieve comparable cure rates to longer regimens while reducing microbiome disruption and minimizing adverse effects [16-18].”
- Authors
- Israelsen, S. B., Fally, M., Tarp, B., Kolte, L., Ravn, P., & Benfield, T.
- Affiliations
- Amager Hospital (DK)
- Bispebjerg Hospital (DK)
- Regionshospitalet Silkeborg (DK)
- Copenhagen University Hospital (DK)
- Herlev Hospital (DK)
- Corresponding author
- Israelsen, Simone Bastrup
- Venue
- Clinical Microbiology and Infection
- Publisher
- Elsevier BV
- Published
- 2023-01
- Volume
- 29
- Issue
- 1
- Pages
- 54-60
- ISSN
- 1198-743X (ISSN-L)
- OpenAlex
- W4296904618
- Cited by
- 15
- References
- 28
- Citations by year
- 2026: 1 · 2025: 6 · 2024: 5 · 2023: 3
- FWCI
- 2.53
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Clinical Microbiology and Infection (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, cc-by)
- Funders
- Gilead Sciences
- Simonsen Foundation
- Novo Nordisk Fonden
- Pfizer
- Erik og Susanna Olesens Almenvelgørende Fond
- Lundbeckfonden
- Ministeriet Sundhed Forebyggelse (ID 1608969)
- Topics
- Health Sciences › Medicine › Epidemiology › Pneumonia and Respiratory Infections
- Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Nosocomial Infections in ICU
- Keywords
- community-acquired pneumonia, short-course antibiotic therapy, long-term antibiotic therapy, antibiotic duration, early clinical response, 30-day mortality, hospital readmission, antibiotic prescribing, hospitalized patients
- MeSH terms
- Aged, Anti-Bacterial Agents, Hospitalization, Humans, Pneumonia, Cohort Studies, Community-Acquired Infections
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