Episode 293: 292. An Antibiotic RCT for Community Acquired Pneumonia

But now we have RCT data—

278 adults with moderate CAP who were hospitalized (but not in intensive care) to receive either a β-lactam antimicrobial plus clarithromycin or a β-lactam alone. (all patients met sepsis or severe sepsis criteria)

composite primary endpoint of improved respiratory symptoms and improved SOFA score by day 4 occurred in significantly more patients in the dual-antibiotic group (68% vs. 38%; number needed to treat, ≈3).

Individuals on dual antibiotics also were significantly less likely to develop sepsis (13% vs. 24%; NNT, 10), significantly more likely to be discharged and alive at 3 months (79% vs. 62%; NNT, 6), and less likely to be readmitted within 90 days (8% vs. 15%; NNT, 14; P=0.09)


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