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Guidelines recommend treating patients who are hospitalized for community-acquired pneumonia (CAP) with a β-lactam antimicrobial plus a macrolide antibiotic (i.e., azithromycin or clarithromycin; NEJM JW Gen Med Dec 1 2019 and Am J Respir Crit Care Med 2019; 200:e45). However, this recommendation is based predominantly on observational studies showing that the combined regimen is associated with higher survival than is monotherapy. To provide randomized trial–level evidence, investigators assigned 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. Enrollment criteria included having 2 or more systemic inflammatory response syndrom…