5 giorni di antibiotico per le polmoniti non complicate sono sufficienti: i risultati di non inferiorità del SAFER RCT

Gruppo di lettura di Reggio Emilia
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Abstract

5 days of antibiotic for uncomplicated pneumonia is enough: the non-inferiority results of the SAFER RCT The most important guidelines for the treatment of community-acquired pneumonia (CAP) indicate amoxicillin as the drug of first choice, however there is a lack of evidence-based indications about the duration of this therapy. This study conducted in 2 emergency departments in Canada randomized 281 children aged 6 months to 10 years with CAP without the need for hospitalization to treatment with high-dose amoxicillin for 5 days versus a traditional 10 day therapy. In terms of clinical recovery, both groups presented comparable results. In fact, the “per protocol” analysis, recommended for a “non-inferiority” design, did not formally provide this result. The exclusively clinical recruitment criteria (any investigations were optional), well reflect the reality of primary care, and the results, albeit with some limitations, suggest that in uncomplicated CAP, brief therapy should be considered in the guidelines.
5天的抗生素治疗无复杂的肺炎就足够了,RCT的结果并不差
最重要的社区获得性肺炎(CAP)治疗指南指出,阿莫西林是首选药物,但缺乏关于这种治疗持续时间的循证指证。这项研究在加拿大的两个急诊科进行,随机选取281名年龄在6个月至10岁之间的CAP患者,无需住院治疗,分别接受5天的大剂量阿莫西林治疗和10天的传统治疗。在临床恢复方面,两组的结果相当。事实上,推荐“非劣效性”设计的“per protocol”分析并没有正式提供这个结果。临床招募标准(任何调查都是可选的)很好地反映了初级保健的现实,尽管存在一些局限性,但结果表明,在不复杂的CAP中,指南应考虑短期治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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