Impact of reducing antibiotic treatment on inflammation among patients with community-acquired pneumonia

Background: The optimal duration of antibiotic treatment for CAP has not been well established. Objective: To evaluate the impact of reducing duration of antibiotic treatment on inflammation measured by inflammation biomarkers. Methods: This was a multicenter randomized clinical trial to validate IDSA/ATS guidelines for duration of antibiotic treatment. Biomarkers could be analyzed among patients of one hospital at day one, 3-5 days as well as at day 30. Biomarkers were proADM, CRP and PCT. Biomarkers were compared between both groups by means of the non-parametric Wilcoxon test. The comparison was also performed adjusting for biomarkers at 3-5 days by means of the general linear models. Results: The median of days with antibiotics in the control group (150 pt) was 10 days and 5 days in the intervention group (162 pt). Blood samples were obtained among 136 patients for biomarkers measurements, 61 and 75 in the control and intervention group, respectively. There were no differences between both groups for proADM, CRP and PCT, neither at day 5 or at day 30, nor for the changes. Table 1 shows proADM values in the control and the intervention groups. The differences remained non-significant after adjusting. Conclusions: Reducing antibiotic treatment in patients with community-acquired pneumonia does not impact on the decrease of inflammation in the follow-up.