community-acquired pneumonia
Conditions
Interventions
Intervention Group:3-day short-course antibiotic therapy (intravenous antibiotics, selected by the attending physician from third-generation cephalosporins, third-generation cephalosporins + clarithro
Control Group:Standard 7-day antibiotic treatment (initial intravenous antibiotics, with possible transition to oral antibiotics during the course as assessed by the attending physician, total antibio
Sponsors
Suzhou Municipal Hospital
Eligibility
Sex/Gender
All
Age
18 Years to 75 Years
Inclusion criteria
Inclusion criteria: 1. Age >= 18 years and 10 x 10^9/L or = 30 breaths/min; 2) Oxygenation index (PaO2/FiO2) = 7.14 mmol/L; 6) Systolic blood pressure 10 x 10^9/L, New lobar or segmental consolidation on chest imaging, Purulent sputum, CRP >= 50 mg/L, PCT >= 0.25 ng/mL; 6. No high-risk factors for infection with drug-resistant bacteria (including Methicillin-resistant Staphylococcus aureus, multidrug-resistant Enterobacterales, Pseudomonas aeruginosa, and other multidrug-resistant Gram-negative bacilli), i.e., Drug-Resistant in Pneumonia (DRIP) score < 4; 7. Voluntary participation in the study with signed informed consent, or informed consent provided by their legally authorized representative;
Exclusion criteria
Exclusion criteria: 1. Known hypersensitivity to cephalosporins, macrolides, quinolones, or tetracyclines; 2. Administration of antibiotics for more than 24 hours within 7 days prior to admission; 3. Discharge from a medical institution within the past 60 days, or a history of more than 3 hospitalizations in the previous 3 years; 4. Blood oxygen saturation 5 x upper limit of normal (ULN), or total bilirubin > 3 x ULN; (3) AST or ALT > 3 x ULN and total bilirubin > 2 x ULN; (4) History of liver cirrhosis; (5) Manifestations of end-stage liver disease (e.g., ascites, hepatic encephalopathy); (6) Neutropenia; (7) Thrombocytopenia; 15. Immunodeficiency or immunocompromised status, including: (1) Primary immunodeficiency disorders; (2) Active or newly diagnosed malignancy within the past 1 year (except localized skin cancer or early-stage cancer); (3) HIV infection; (4) Chemotherapy, radiotherapy, or targeted therapy within the past 1 year; (5) Solid organ transplantation or hematopoietic stem cell transplantation; (6) Treatment with >= 20 mg prednisone or equivalent daily for >= 14 consecutive days within the past month; (7) Long-term use of glucocorticoids at 10 mg/day prednisone or equivalent, with a cumulative dose > 600 mg prednisone within the past month; (8) Receipt of biological immunomodulators or anti-rheumatic/other immunosuppressive agents (e.g., cyclosporine, cyclophosphamide, hydroxychloroquine, methotrexate) within the past month; 16. Pregnancy or lactation; 17. Participation in another clinical trial;
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Clinical cure rate; | — |
Secondary
| Measure | Time frame |
|---|---|
| Pneumonia recurrence rate;Treatment failure rate;Readmission rate;Symptom improvement;Time to clinical stability;Total hospitalization duration;Hospitalization cost;Safety outcomes (including incidence of adverse events, serious adverse events, vital signs, laboratory tests, QT interval prolongation, ventricular tachycardia, hepatic insufficiency); | — |
Countries
China
Contacts
Public ContactLin Dang
Suzhou Municipal Hospital
Outcome results
None listed