Antibiotics for Pneumonia: Can Courses Get Even Shorter?

Treatment guidelines for community-acquired pneumonia (CAP) have long recommended at least 5 days of antibiotics, but newer guidance suggests shorter courses (3–4 days) may be appropriate for nonsevere cases once patients achieve clinical stability (Figure 1). To assess this recommendation in real-world practice, investigators studied 55,000 adults hospitalized with CAP and identified about 10% who were eligible for short-course treatment (i.e., clinically stable by hospital day 3, based on vital signs and mentation).

These 5620 low-risk patients were then assessed in a target trial emulation study, comparing short-course antibiotic treatment (3–4 days) with longer-course treatment (≥5 days). Exclusions were patients with severe pulmo…