Shorter antibiotic courses show similar outcomes to longer use for some pneumonia patients: Study

A multicenter target trial emulation found that for eligible patients hospitalized with community-acquired pneumonia (CAP), health outcomes were similar whether they received a three- to four-day course of antibiotics or a course lasting five days or more.

The findings suggest that for a selected subset of patients with early clinical stability, shorter treatment durations may be just as safe and effective as traditional longer regimens. The study is published in Annals of Internal Medicine.

Researchers from the University of Texas Southwestern, University of Michigan Medical School, University of Utah School of Medicine, and colleagues sought to evaluate whether short antibiotic courses are safe for adults hospitalized with CAP who show early clinical stability.

Researchers analyzed data from patients across 67 Michigan hospitals between 2017 and 2024 to compare outcomes for patients who received three to four days of antibiotics with those treated for five days or longer. Only 10% of patients met the strict criteria for short-course therapy, and among them, the study found no meaningful differences in mortality, readmissions, urgent care visits, or C. difficile infections. These findings suggest that shorter treatment may be appropriate for clinically stable patients.

However, the small number of short-course cases warrants further study.

Reference:

George Doumat, David Ratz, Jennifer K. Horowitz, et al. Short Versus Longer Antibiotic Duration for Community-Acquired Pneumonia: A Multicenter Target Trial Emulation. Ann Intern Med. [Epub 14 April 2026]. doi:10.7326/ANNALS-25-03538