Do Antibiotics Benefit Patients Hospitalized with Viral Pneumonia?

Management of hospitalized patients with community-acquired pneumonia (CAP) and a positive respiratory viral assay remains controversial. The 2025 American Thoracic Society CAP guidelines issued a conditional recommendation to administer antibiotics to all hospitalized patients with CAP and a positive viral assay, citing the difficulty in recognizing bacterial coinfection and the potential harm from delayed antimicrobials (see Figure 1). However, the Infectious Diseases Society of America did not endorse this recommendation, emphasizing that routine antibiotic use causes more harm than good.

To help address this controversy, researchers conducted a multicenter, retrospective study examining the association between antibiotic use and o…