Prolonged antibiotics use not effective in reducing all-cause, pneumonia 30-day readmissions

Extended use of antibiotic therapy for the treatment of community-onset pneumonia does not appear to reduce the rates of all-cause or pneumonia-specific 30-day readmission, a study has found.

“Recent publications have confirmed that 70 percent of hospitalized adults with uncomplicated community-acquired pneumonia and healthcare-associated pneumonia are prescribed a duration therapy that exceeds current guideline recommendations,” the authors said.

To assess the relationship between antibiotic duration and all-cause 30-day readmission rates, patients aged ≥18 years with a primary diagnosis of pneumonia from 1 January 2016 to 31 December 2016 were enrolled in this single-centre, retrospective cohort study.

The authors categorized patients by antibiotic therapy duration of 7 days (n=139) or >7 days (n=286) and analysed outcomes in both bivariate and multivariate models. They used a multivariate logistic regression to examine the association between all-cause 30-day readmission and antibiotic days.

Patients in the two treatment groups did not significantly differ in baseline characteristics. All-cause 30-day readmission rate was 15.8 percent for patients who received ≤7 days of antibiotics compared with 15.5 percent for those who received >7 days of therapy (p=0.95).

Pneumonia-specific 30-day readmission occurred in 3.6 percent and 3.5 percent of patients who received antibiotics for ≤7 and >7 days, respectively (p=0.95).

In multivariate analysis, no statistically significant association was observed between readmission rate and antibiotic duration of >7 days. In addition, the following risk factors were found to be statistically significant: three or more hospital admissions within the previous year, haematocrit <30 percent at discharge, history of chronic obstructive pulmonary disorder, and weight.