Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026
Outcomes Associated With Empiric Azithromycin Use Among Patients Hospitalized With Nonsevere Community-Acquired Pneumonia: Emulation of a Target Trial.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Gupta Ashwin B, Walzl Emily, Ratz David, Horowitz Jennifer K, McLaughlin Elizabeth, Pearlman Tara, Czilok Tawny, Gandhi Tejal, Petty Lindsay A, Malani Anurag N, Paje David, Misra Preeti, Kaatz Scott, Bernstein Steven, Younas Mariam, Flanders Scott A, Vaughn Valerie M
Аннотация
BACKGROUND: There remains equipoise regarding the benefit of empiric azithromycin with beta-lactam therapy in patients hospitalized with nonsevere community-acquired pneumonia (CAP).
METHODS: We performed a target trial emulation using a propensity-weighted cohort from 68 hospitals in Michigan. Adult patients hospitalized with nonsevere CAP receiving beta-lactam antimicrobial therapy with or without azithromycin were included. CAP was defined based on the International Classification of Diseases, Tenth Revision, discharge diagnosis code of pneumonia and ≥2 signs/symptoms of pneumonia with radiographic findings. The primary outcome was time (days) to clinical stability. Secondary outcomes included composite 30-day mortality and rehospitalization, intensive care unit (ICU) transfer, and antibiotic duration.
RESULTS: Of 66 657 patients hospitalized for CAP between September 2015 and July 2024, 28.5% (19 010) met inclusion criteria, of whom 93.8% (17 822 of 19 010) received empiric azithromycin. After inverse probability of treatment weighting, there was no difference in time to clinical stability for those reciving azithromycin (vs not) (3 [interquartile range, IQR 3-4] vs 3 days [IQR 3-4]; adjusted hazard ratio [aHR], 1.00 [0.96-1.05]; P = .91). Empiric azithromycin was associated with lower composite 30-day mortality and rehospitalization (10.8% vs 15.1%; aHR, 0.73 [0.62-0.87]; P = .0004). There were no differences in ICU transfer (0.9% vs 1.4%; aHR, 0.85 [0.48-1.49]; P = .57) or total antibiotic duration (6 [IQR 5-8] vs 7 [IQR 5-9] days, P = .23).
CONCLUSIONS: Adding azithromycin to beta-lactam therapy in patients hospitalized with nonsevere CAP was not associated with time to clinical stability but was associated with lower composite 30-day mortality and rehospitalization.
METHODS: We performed a target trial emulation using a propensity-weighted cohort from 68 hospitals in Michigan. Adult patients hospitalized with nonsevere CAP receiving beta-lactam antimicrobial therapy with or without azithromycin were included. CAP was defined based on the International Classification of Diseases, Tenth Revision, discharge diagnosis code of pneumonia and ≥2 signs/symptoms of pneumonia with radiographic findings. The primary outcome was time (days) to clinical stability. Secondary outcomes included composite 30-day mortality and rehospitalization, intensive care unit (ICU) transfer, and antibiotic duration.
RESULTS: Of 66 657 patients hospitalized for CAP between September 2015 and July 2024, 28.5% (19 010) met inclusion criteria, of whom 93.8% (17 822 of 19 010) received empiric azithromycin. After inverse probability of treatment weighting, there was no difference in time to clinical stability for those reciving azithromycin (vs not) (3 [interquartile range, IQR 3-4] vs 3 days [IQR 3-4]; adjusted hazard ratio [aHR], 1.00 [0.96-1.05]; P = .91). Empiric azithromycin was associated with lower composite 30-day mortality and rehospitalization (10.8% vs 15.1%; aHR, 0.73 [0.62-0.87]; P = .0004). There were no differences in ICU transfer (0.9% vs 1.4%; aHR, 0.85 [0.48-1.49]; P = .57) or total antibiotic duration (6 [IQR 5-8] vs 7 [IQR 5-9] days, P = .23).
CONCLUSIONS: Adding azithromycin to beta-lactam therapy in patients hospitalized with nonsevere CAP was not associated with time to clinical stability but was associated with lower composite 30-day mortality and rehospitalization.