Conference Coverage

Three days of beta-lactam beat clinically stable CAP

 

Key clinical point: Three days of beta-lactam treatment were as effective as 8 days in curing clinically stable patients with community-acquired pneumonia.

Major finding: Cure rates at 15 days were 69.9% in the 3-day group, compared with 61.2% in the 8-day group, a nonsignificant difference.

Study details: The placebo-controlled study randomized 310 patients to treatment.

Disclosures: The French Ministry of Health sponsored the trial. Dr. Dinh had no financial disclosures.

Source: Dinh et al. ECCMID 2018, oral abstract O1126.


 

REPORTING FROM ECCMID 2018

– Three days of beta-lactam therapy was just as effective as 8 days for clinically stable patients presenting with community-acquired pneumonia.

In a randomized, placebo-controlled trial, 15-day cure rates were 69.9% in patients who took 3 days of antibiotics and 61.2% in those who took 8 days – a nonsignificant difference, Aurélien Dinh, MD, said at the European Society of Clinical Microbiology and Infectious Diseases annual congress.

Dr. Aurélien DinhUniversity of Paris Hospital Michele G Sullivan/MDedge News

Dr. Aurélien Dinh

The French study was one of a series at the meeting demonstrating that, for some groups of patients, short-term antibiotic therapy is a viable – and probably healthy – alternative to the traditional longer courses, said Dr. Dinh of the University of Paris Hospital.

“Reducing treatment time now appears to be manageable and effective in a number of infectious diseases,” Dr. Dinh explained. “Although there are some limits, surely, this change in practice might lead to reduced rates of multidrug-resistant bacteria, fewer adverse events, and surely lower costs.”

The French PTC Trial (Short Duration Treatment of Non-Severe Community-Acquired Pneumonia) randomized 310 patients (mean age, 73.5 years) to either short- or long-course treatment with a beta-lactam antibiotic. Patients were eligible for the study if they were admitted to the hospital for community-acquired pneumonia based on respiratory signs, fever of 38° C or higher, and evidence of new infiltrate on chest radiograph.

All patients were treated with 3 days of amoxicillin/clavulanic acid (Augmentin) or third-generation cephalosporin. Those who had responded clinically by day 3 entered the 5-day randomization period, receiving placebo or 5 more days of active therapy with the same agent.

Clinical requirements for randomization included being afebrile with stable heart and respiratory rate, a systolic blood pressure of at least 90 mm Hg, and oxygen saturation of at least 90%.

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