Intended for healthcare professionals


Effectiveness of discontinuing antibiotic treatment after three days versus eight days in mild to moderate-severe community acquired pneumonia: randomised, double blind study

BMJ 2006; 332 doi: (Published 08 June 2006) Cite this as: BMJ 2006;332:1355

Why IV antibiotics for mild community acquired pneumonia?

Sir, Few points to consider in Dr El Moussaoui et al research:

• As mentioned in Dr El Moussaoui et al paper the duration of
antibiotic treatment in pneumonia is not evidence based, however most
physicians treat mild community acquired pneumonia with oral antibiotics
for approximately a week. It was not clear, in the paper, what is the
rationale of treating mild community acquired pneumonia with intravenous
antibiotics; especially that IV treatment is not without its risks.

• The study did not include patients who are 75 and older, who
constitute a considerable proportion of hospitalized patients with

• It is difficult to justify repeating chest XR on day 10 and day 28
for asymptomatic and clinically improving patients.

• The researchers wisely reiterated that a shorter antibiotic
treatment period may not be inferior to a longer period for those who have
substantially improved after an initial three days' treatment. As usual
clinical sense is of a paramount importance.

Competing interests:
None declared

Competing interests: No competing interests

13 June 2006
Atef Michael
Specialist Registrar
City Hospital, Birmingham,UK