Skip to content

Research at St Andrews

Short-course versus long-course therapy of the same antibiotic for community-acquired pneumonia in adolescent and adult outpatients

Research output: Contribution to journalReview article


Jesús López-Alcalde, Ricardo Rodriguez-Barrientos, Jesús Redondo-Sánchez, Javier Muñoz-Gutiérrez, José María Molero García, Carmen Rodríguez-Fernández, Julio Heras-Mosteiro, Jaime Marin-Cañada, Jose Casanova-Colominas, Amaya Azcoaga-Lorenzo, Virginia Hernandez Santiago, Manuel Gómez-García

School/Research organisations


BACKGROUND: Community-acquired pneumonia (CAP) is a lung infection that can be acquired during day-to-day activities in the community (not while receiving care in a hospital). Community-acquired pneumonia poses a significant public health burden in terms of mortality, morbidity, and costs. Shorter antibiotic courses for CAP may limit treatment costs and adverse effects, but the optimal duration of antibiotic treatment is uncertain.

OBJECTIVES: To evaluate the efficacy and safety of short-course versus longer-course treatment with the same antibiotic at the same daily dosage for CAP in non-hospitalised adolescents and adults (outpatients). We planned to investigate non-inferiority of short-course versus longer-term course treatment for efficacy outcomes, and superiority of short-course treatment for safety outcomes.

SEARCH METHODS: We searched CENTRAL, which contains the Cochrane Acute Respiratory Infections Group Specialised Register, MEDLINE, Embase, five other databases, and three trials registers on 28 September 2017 together with conference proceedings, reference checking, and contact with experts and pharmaceutical companies.

SELECTION CRITERIA: Randomised controlled trials (RCTs) comparing short- and long-courses of the same antibiotic for CAP in adolescent and adult outpatients.

DATA COLLECTION AND ANALYSIS: We planned to use standard Cochrane methods.

MAIN RESULTS: Our searches identified 5260 records. We did not identify any RCTs that compared short- and longer-courses of the same antibiotic for the treatment of adolescents and adult outpatients with CAP.We excluded two RCTs that compared short courses (five compared to seven days) of the same antibiotic at the same daily dose because they evaluated antibiotics (gemifloxacin and telithromycin) not commonly used in practice for the treatment of CAP. In particular, gemifloxacin is no longer approved for the treatment of mild-to-moderate CAP due to its questionable risk-benefit balance, and reported adverse effects. Moreover, the safety profile of telithromycin is also cause for concern.We found one ongoing study that we will assess for inclusion in future updates of the review.

AUTHORS' CONCLUSIONS: We found no eligible RCTs that studied a short-course of antibiotic compared to a longer-course (with the same antibiotic at the same daily dosage) for CAP in adolescent and adult outpatients. The effects of antibiotic therapy duration for CAP in adolescent and adult outpatients remains unclear.



Original languageEnglish
Article numberCD009070
Number of pages37
JournalCochrane Database of Systematic Reviews
Early online date6 Sep 2018
Publication statusE-pub ahead of print - 6 Sep 2018

Discover related content
Find related publications, people, projects and more using interactive charts.

View graph of relations

Related by author

  1. Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy: study protocol of a cluster randomized clinical trial (Multi-PAP project)

    Prados-Torres, A., del Cura-González, I., Prados-Torres, D., López-Rodríguez, J. A., Leiva-Fernández, F., Calderón-Larrañaga, A., López-Verde, F., Gimeno-Feliu, L. A., Escortell-Mayor, E., Pico-Soler, V., Sanz-Cuesta, T., Bujalance-Zafra, M. J., Morey-Montalvo, M., Boxó-Cifuentes, J. R., Poblador-Plou, B., Fernández-Arquero, J. M., González-Rubio, F., Ramiro-González, M. D., Coscollar-Santaliestra, C., Martín-Fernández, J. & 7 others, Barnestein-Fonseca, M. P., Valderas-Martínez, J. M., Marengoni, A., Muth, C., Multi-PAP Group, Hernández-Santiago, V. & Azcoaga-Lorenzo, A., 27 Apr 2017, In : Implementation Science. 12, 10 p., 54.

    Research output: Contribution to journalArticle

  2. Effectiveness of a strategy that uses educational games to implement clinical practice guidelines among Spanish residents of family and community medicine (e-EDUCAGUIA project): A clinical trial by clusters

    del Cura-González, I., López-Rodríguez, J. A., Sanz-Cuesta, T., Rodríguez-Barrientos, R., Martín-Fernández, J., Ariza-Cardiel, G., Polentinos-Castro, E., Román-Crespo, B., Escortell-Mayor, E., Rico-Blázquez, M., Hernández-Santiago, V., Azcoaga-Lorenzo, A., Ojeda-Ruiz, E., González-González, A. I., Ávila-Tomas, J. F., Barrio-Cortés, J., Molero-García, J. M., Ferrer-Peña, R., Tello-Bernabé, M. E., Trujillo-Martín, M. & 31 others, Barral, A. G., Moreno, A. F., Pérez, P. C., Barba, E. C., Rodríguez Monje, M. T., Iturbe, A. G., Crespo, L. I. M., Mañeru, M. E. M., de Gómez Barragan, M. J. G., Elustondo, S. G., Fuertes, R. R., Cabello Ballesteros, L. M., Nido, R. Á., Moreno, C. B., Rojas, G. C., Rivas, J. L. L., Pikatza, A. Z., Celaya, C. S., Montalvo, M. M., Almeida, L. P. C., álamo Rodríguez, M. D., García-Franco, A. L., Weismann, E. C., álvarez, R. M., Bustillo, B. M., del Pozo, M. S. C., Perruca, L. S., Salinero Fort, M. Á., de Burgos Luna, C., SanJuan, A. M. & Educaguia Group, 17 May 2016, In : Implementation Science. 11, 10 p., 71.

    Research output: Contribution to journalArticle

  3. Changes in resistance among coliform bacteraemia associated with a primary care antimicrobial stewardship intervention: a population-based interrupted time series study

    Hernandez-Santiago, V., Davey, P. G., Nathwani, D., Marwick, C. A. & Guthrie, B., 7 Jun 2019, In : PLoS Medicine. 16, 6, 19 p., e1002825.

    Research output: Contribution to journalArticle

  4. Exploring the training and scope of practice of GPs in England, Germany and Spain

    Glonti, K., Struckmann, V., Alconada, A., Pettigrew, L. M., Hernandez-Santiago, V., Minue, S., Risso-Gill, I., McKee, M. & Legido-Quigley, H., Mar 2019, In : Gaceta Sanitaria. 33, 2, p. 148-155

    Research output: Contribution to journalArticle

  5. Modelo de seguimiento, organización y gestión de la infección por VIH

    Berenguer, J., Álvarez, D., Dodero, J. & Azcoaga, A., Sep 2018, In : Enfermedades Infecciosas y Microbiologia Clinica. 36, Suppl 1, p. 45-49 5 p.

    Research output: Contribution to journalArticle

Related by journal

  1. Antiviral treatment for Bell’s palsy (Idiopathic facial paralysis)

    Gagyor, I., Madhok, V. B., Daly, F. & Sullivan, F., 5 Sep 2019, In : Cochrane Database of Systematic Reviews. 2019, 9, p. 1-68 68 p., CD001869.

    Research output: Contribution to journalReview article

  2. Linezolid for drug-resistant pulmonary tuberculosis

    Singh, B., Cocker, D., Ryan, H. & Sloan, D. J., 20 Mar 2019, In : Cochrane Database of Systematic Reviews. 2019, 3, CD012836.

    Research output: Contribution to journalReview article

  3. Interventions to increase attendance for diabetic retinopathy screening

    Lawrenson, J. G., Graham-Rowe, E., Lorencatto, F., Burr, J., Bunce, C., Francis, J. J., Aluko, P., Rice, S., Vale, L., Peto, T., Presseau, J., Ivers, N. & Grimshaw, J. M., 15 Jan 2018, In : Cochrane Database of Systematic Reviews. 1, 251 p., CD012054.

    Research output: Contribution to journalReview article

  4. Strategies to improve recruitment to randomised trials

    Treweek, S., Pitkethly, M., Cook, J., Fraser, C., Mitchell, E., Sullivan, F., Jackson, C., Taskila, T. & Gardner, H., 22 Feb 2018, In : Cochrane Database of Systematic Reviews. 133 p.

    Research output: Contribution to journalReview article

ID: 255817974