To evaluate the clinical success of short-course (≤5 days) versus long-course (>5 days) antibiotic therapies in adults with community-acquired pneumonia (CAP) and analyze secondary outcomes including adverse events.
Approach:
Systematic Review and Meta-Analysis: Conducted a systematic search of PubMed, Embase, and CENTRAL for RCTs comparing short-course and long-course antibiotic therapies in adults with CAP, following PRISMA 2020 guidelines.
Key Findings:
Short-course antibiotic therapy achieved comparable efficacy to long-course therapy in clinical success (RR = 1.00, p = 0.77).
Bacteriological success was also similar between both regimens (RR = 1.00, p = 0.86).
Short-course therapy showed a marginally higher risk of mild treatment-related adverse events (RR = 1.12, p = 0.04).
There was a non-significant downward trend in treatment-related serious adverse events (RR = 0.37, p = 0.07).
Most studies included demonstrated generally acceptable methodological quality with low risk of bias.
Interpretation:
Limitations:
Evidence comparing short-course and long-course regimens remains fragmented across trials with varying designs.
Individual RCTs may be underpowered to detect nuanced differences in secondary outcomes.
