Short- versus Long-Course Antibacterial Therapy for Community-Acquired Pneumonia: A Meta-Analysis
Abstract
Background The evidence for traditionally recommended 7- to 14-day duration of antibacterial therapy for community-acquired pneumonia (CAP) is not well established. Objectives We endeavoured to assess the effectiveness and safety of shorter than traditionally recommended antibacterial therapy for CAP. Methods We performed a meta-analysis of randomized controlled trials (RCTs) comparing short- ( or = 2 days difference) course therapy for CAP with the same antibacterial regimens, in the same daily dosages. Results Five RCTs involving adults (including outpatients and inpatients who did not require intensive care) and two RCTs involving children (aged 2-59 months, residing in developing countries) were included. All RCTs were double-blind and assessed patients with CAP of mild to moderate severity. No differences were found between short- (adults 3-7 days; children 3 days) and long- (adults 7-10 days; children 5 days) course regimens (adults - amoxicillin, cefuroxime, ceftriaxone, telithromycin and gemifloxacin; children - amoxicillin) regarding clinical success at end-of-therapy (six RCTs; 5107 patients [1095 adults, 4012 children]; fixed-effect model [FEM]; odds ratio [OR] = 0.89; 95% CI 0.74, 1.07), clinical success at late follow-up, microbiological success, relapses, mortality (seven RCTs; 5438 patients; FEM; OR = 0.57; 95% CI 0.23, 1.43), adverse events (five RCTs; 3214 patients; FEM; OR = 0. 90; 95% CI 0.72, 1.13) or withdrawals as a result of adverse events. No differenc…
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Administration of a loading dose of antibiotic before prolonged infusion is essential to avoid delays to achieving effective beta-lactam concentrations.
“Administration of a loading dose of antibiotic before prolonged infusion is essential to avoid delays to achieving effective beta-lactam concentrations (234).”
From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [234]
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- Authors
- Dimopoulos, G., Matthaiou, D. K., Karageorgopoulos, D. E., Grammatikos, A. P., Athanassa, Z., & Falagas, M. E.
- Affiliations
- Alfa Institute of Biomedical Sciences (GR)
- Tufts University (US)
- ORCID
- Venue
- Drugs
- Published
- 2008
- Volume
- 68
- Issue
- 13
- Pages
- 1841-1854
- ISSN
- 0012-6667 (ISSN-L)
- OpenAlex
- W2026082339
- Cited by
- 160
- References
- 1
- Citations by year
- 2026: 2 · 2025: 8 · 2024: 8 · 2023: 8 · 2022: 11 · 2021: 15 · 2020: 8 · 2019: 5 · 2018: 13 · 2017: 6 · 2016: 16 · 2015: 7 · 2014: 8 · 2013: 10 · 2012: 4
- FWCI
- 7.57
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Drugs (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Pneumonia and Respiratory Infections
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Pleural and Pulmonary Diseases
- Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
- Keywords
- community-acquired pneumonia, short-course antibiotic therapy, antibiotic duration, antibiotic therapy, amoxicillin, cefuroxime, ceftriaxone, telithromycin, gemifloxacin, pediatric pneumonia, adverse drug reactions, relapse, mortality
- MeSH terms
- Administration, Oral, Adult, Age Factors, Anti-Bacterial Agents, Child, Preschool, Drug Administration Schedule, Follow-Up Studies, Humans, Infant, Pneumonia, Time Factors, Randomized Controlled Trials as Topic, Treatment Outcome, Community-Acquired Infections
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