ID:IOTS - Infectious Disease Insight Of Two Specialists 39. ID:IOTS Journal Club: 3 days treatment for CAP
Jan 23, 2023
Discover a groundbreaking discussion on community-acquired pneumonia treatment, specifically the potential to safely shorten antibiotic use to just three days. The hosts delve into the importance of antibiotic stewardship and compare new findings with traditional eight-day regimens. They examine pneumonia risk scoring systems, advocating for better integration in healthcare. The conversation highlights the challenges of data-driven decision support, emphasizing the need for effective communication in clinical guidelines and practices.
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Only Stop After Clinical Response
- Only randomize clinically responding inpatients at 72 hours to shorter therapy trials.
- Require normal vitals and mental status before stopping beta-lactams at day three.
Three Days Versus Eight Days Examined
- The trial tested stopping antibiotics at 72 hours versus continuing five more days of amoxicillin-clavulanate.
- Initial therapy in the study was either amoxicillin-clavulanate or a third-generation cephalosporin.
Risk Scores In Trial Design
- The trial used permuted-block randomization stratified by site and PSI score.
- PSI is complex and research-focused, while CURB-65 remains popular for bedside simplicity.