SHM Converge Scientific Abstract ePoster Gallery-3-Day Antibiotic Duration in Patients With Pneumonia: A 68-Hospital Cohort

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This study examined antibiotic duration for hospitalized patients with community-acquired pneumonia (CAP) across 68 Michigan hospitals from 2017 to 2022. The goal was to determine how many patients would qualify for a 3-day antibiotic course based on criteria from a prior clinical trial, how often shorter 3–4 day courses were used, and whether outcomes differed compared with the standard 5-day course.<br /><br />Among 36,064 patients with CAP, only 24.6% were eligible for 3-day therapy. Many were excluded because of complicated infection, specific organisms, comorbidities, or clinical instability on hospital day 3. Use of 3–4 day durations increased over time, but remained uncommon.<br /><br />When patients eligible for short therapy received 3–4 days instead of 5 days, outcomes were worse. The composite 30-day adverse outcome occurred more often in the shorter-duration group, as did mortality and readmission. Urgent visits and antibiotic-associated adverse events were not significantly different. The adjusted odds ratio for the composite adverse outcome was 1.20, with increased odds of mortality and readmission as well.<br /><br />The authors concluded that fewer than one in four general-care CAP patients are truly eligible for 3-day treatment, and the limited use of 3–4 day courses likely reflects empiric antibiotic treatment in patients who may not actually have CAP, rather than intentional short-course management. Given the small eligible population and the potential for harm, they suggest that efforts should focus on improving appropriate use of 5-day therapy rather than broadly shortening treatment to 3 days.

Asset Subtitle

Valerie M. Vaughn

Meta Tag

Author List Anurag N. Malani, Danielle Osterholzer, David Ratz, Elizabeth McLaughlin, Jennifer K. Horowitz, Lindsay A. Petty, Scott A. Flanders, Tawny Czilok, Tejal N. Gandhi, Valerie M. Vaughn

Category Research

Concept Community-Acquired Pneumonia

Concept Antibiotic Duration

Concept Five-Day Therapy

Concept Three-Day Therapy

Concept Clinical Stability

Distinguished Non-Finalist

Presenter Organization University of Utah

Presenting Author Valerie M. Vaughn

Track Patient Safety

Keywords

community-acquired pneumonia

antibiotic duration

3-day therapy

5-day course

hospitalized patients

Michigan hospitals

clinical trial criteria

short-course antibiotics

30-day adverse outcome

mortality and readmission

Community-Acquired Pneumonia

Antibiotic Duration

Five-Day Therapy

Three-Day Therapy

Clinical Stability