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ACP Journal Club |15 September 2015

In non-ICU suspected CAP, β-lactam was noninferior to β-lactam–macrolide or fluoroquinolone for 90-d mortality

Thomas Fekete, MD

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Postma DF, van Werkhoven CH, van Elden LJ, et al; CAP-START Study Group. Antibiotic treatment strategies for community-acquired pneumonia in adults. N Engl J Med. 2015;372:1312-23. 25830421

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In patients with suspected community-acquired pneumonia (CAP) admitted to non–intensive care unit (ICU) wards, is β-lactam monotherapy (BL) noninferior to β-lactam plus a macrolide (BLM) or fluoroquinolone monotherapy (FQL) for 90-day mortality?
Cluster randomized, crossover, noninferiority trial (Community-Acquired Pneumonia–Study on the Initial Treatment with Antibiotics of Lower Respiratory Tract Infections [CAP-START]). ClinicalTrials.gov NCT01660204. In 1 of 7 clusters, crossover between 2 treatment periods was interrupted because of fluoroquinolone supply problems.
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Fekete T. In non-ICU suspected CAP, β-lactam was noninferior to β-lactam–macrolide or fluoroquinolone for 90-d mortality. Ann Intern Med. ;163:JC5. doi: 10.7326/ACPJC-2015-163-6-005

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Published: Ann Intern Med. 2015;163(6):JC5.

DOI: 10.7326/ACPJC-2015-163-6-005

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