Is Short-Course Antibiotic Treatment for CAP Effective?

For adults with community-acquired pneumonia (CAP), receiving a short-course of antibiotics (6 days or less) may be equally as effective and possibly better than long-course treatment, according to a systematic review and meta-analysis published in Antimicrobial Agents and Chemotherapy.

To investigate what impact antibiotic treatment duration has on CAP outcomes, researchers from the Warren Alpert Medical School of Brown University conducted a search of various databases for studies comparing the safety and efficacy of treatment regimens lasting ≤6 days (short) and ≥7 days (long). A total of 21 trials were identified (N=4861); 19 of these trials were randomized. 

Results showed clinical cure was comparable between the two groups (risk ratio [RR] 0.99, 95% CI, 0.97-1.01), regardless of outpatient (RR 0.98, 95% CI, 0.96-1.00) or inpatient (RR 1.00, 95% CI, 0.92-1.09) setting or pneumonia severity (RR 1.05, 95% CI, 0.96-1.14). Moreover, relapses were similar between both groups (N=1923; RR 0.67, 95% CI, 0.30-1.46). Regarding safety, there were fewer serious adverse events among patients in the short-course treatment arm (N=1923; RR 0.73, 95% CI, 0.55-0.97), which resulted in decreased mortality, vs the long-course treatment arm (N=2802; RR 0.52, 95% CI, 0.33-0.82). 

Overall, the researchers concluded that “in CAP, short-course antibiotic treatment (≤6 days) is equally effective and potentially superior, in terms of mortality and serious adverse events, compared to longer-course treatment.”

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