2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T5b3,We review recent evidence on the effectiveness of non-antimicrobial adjunctive interventions on the recovery of adults diagnosed with community-acquired pneumonia (CAP). Respiratory physiotherapy, early mobilization or tailored exercises may decrease length of stay (LoS), dyspnoea and readmissions, but there is little evidence of an effect on mortality. Nutritional interventions may decrease readmissions and improve 30-day mortality, but there are few studies on the effect of individual micronutrient supplementation. Strategies to improve discharge communications and patient education may decrease readmission rates, improve treatment compliance and patient satisfaction, whereas the implementation of guidelines and care bundles may decrease 30-day mortality but does not appear to affect length of stay or 30-day readmissions. For adjunctive therapeutic interventions, there is evidence that for severe CAP, corticosteroids probably decrease short-term mortality and possibly longer term mortality and LoS. Antiplatelet agents and statins may decrease short-term mortality. A wide range of adjunctive interventions have been trialled aiming to improve patient outcomes with variable results and considerable heterogeneity between studies and populations. Future studies should involve engagement with patient groups to identify uncertainties and outcomes they consider important, utilize a core set of outcome measures, and assess long-term outcomes.31:T772, Purpose of review We review recent evidence on the effectiveness of non-antimicrobial adjunctive interventions on the recovery of adults diagnosed with community-acquired pneumonia (CAP). Recent findings Respiratory physiotherapy, early mobilization or tailored exercises may decrease length of stay (LoS), dyspnoea and readmissions, but there is little evidence of an effect on mortality. Nutritional interventions may decrease readmissions and improve 30-day mortality, but there are few studies on the effect of individual micronutrient supplementation. Strategies to improve discharge communications and patient education may decrease readmission rates, improve treatment compliance and patient satisfaction, whereas the implementation of guidelines and care bundles may decrease 30-day mortality but does not appear to affect length of stay or 30-day readmissions. For adjunctive therapeutic interventions, there is evidence that for severe CAP, corticosteroids probably decrease short-term mortality and possibly longer term mortality and LoS. Antiplatelet agents and statins may decrease short-term mortality. Summary A wide range of adjunctive interventions have been trialled aiming to improve patient outcomes with variable results and considerable heterogeneity between studies and populations. Future studies should involve engagement with patient groups to identify uncertainties and outcomes they consider important, utilize a core set of outcome measures, and assess long-term outcomes. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Community-Acquired Pneumonia: condition Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Community-Acquired Pneumonia (condition). Clinician-written summaries and actionable practice insights. Updated daily.\",\"url\":\"https://www.reachrx.ai/hub/tag/condition/Community-Acquired%20Pneumonia\",\"breadcrumb\":{\"@type\":\"BreadcrumbList\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https://www.reachrx.ai\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Research Hub\",\"item\":\"https://www.reachrx.ai/hub\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Conditions\",\"item\":\"https://www.reachrx.ai/hub/tag/condition\"},{\"@type\":\"ListItem\",\"position\":4,\"name\":\"Community-Acquired Pneumonia\",\"item\":\"https://www.reachrx.ai/hub/tag/condition/Community-Acquired%20Pneumonia\"}]}}"}}]],["$","$L2f",null,{"title":"Community-Acquired Pneumonia: Research & Clinical Takeaways","description":"Discover peer-reviewed research on Community-Acquired Pneumonia with concise clinician summaries and next-step guidance.","papers":[{"doi":"10.1016/j.jaci.2026.08.001","pmid":"42695953","title":"Neutralizing autoantibodies against IL-1Ra in severe bacterial community-acquired pneumonia","journal_title":"Journal of Allergy and Clinical Immunology","journal_issn":"0091-6749","published_at":"2026-09-04T00:00:00.000Z","url":"https://doi.org/10.1016/j.jaci.2026.08.001","source_score":5,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-09-11T06:20:05.290Z","updated_at":"2026-09-11T06:20:05.290Z","tags":[{"paper_doi":"10.1016/j.jaci.2026.08.001","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.08.001","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.08.001","tag_type":"condition","value":"Bacterial Pneumonia","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.08.001","tag_type":"condition","value":"Community-Acquired Pneumonia","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.08.001","tag_type":"generic","value":"anakinra","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.08.001","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.08.001","tag_type":"modality","value":"Autoantibody Detection","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.08.001","tag_type":"warning","value":"Only the paper metadata was provided — no abstract, methods, results, or discussion text was available. All structured content is inferred from the title and journal context alone; key details such as sample size, study design, patient demographics, and specific outcomes are unknown and could not be extracted.","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.08.001","tag_type":"warning","value":"The generic tag 'anakinra' (recombinant IL-1Ra) is included as a clinically relevant agent in this context but is not explicitly confirmed as studied or mentioned in the source text.","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.08.001","tag_type":"warning","value":"The study_design and level_of_evidence tags were omitted because the design cannot be determined from the title alone.","value_numeric":null}],"summaries":{"what_studied":"The study evaluated the presence and role of neutralizing autoantibodies against IL-1 receptor antagonist (IL-1Ra) in patients with severe bacterial community-acquired pneumonia (CAP).","key_result":"Neutralizing autoantibodies against IL-1Ra were identified in a subset of patients with severe bacterial CAP, suggesting these autoantibodies may impair IL-1Ra function and contribute to dysregulated inflammation in this condition.","limitations":"The paper abstract provides limited methodological detail, making it difficult to assess sample size, study design rigor, and generalizability of findings.","practice_takeaway":"Clinicians should be aware that neutralizing anti-IL-1Ra autoantibodies may underlie hyperinflammatory presentations in some patients with severe bacterial CAP. Screening for these autoantibodies could eventually help identify patients who might benefit from IL-1 pathway–targeted therapies."}},{"doi":"10.1093/cid/ciag438","pmid":"42640090","title":"IDSA/ACEP/ASM/PIDS/SCCM/SHEA/SHM/SIDP Multisociety Position Paper: Hospital Strategies to Improve Sepsis Outcomes","journal_title":"Clinical Infectious Diseases","journal_issn":"1058-4838","published_at":"2026-08-25T00:00:00.000Z","url":"https://doi.org/10.1093/cid/ciag438","source_score":51,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-29T06:19:15.720Z","updated_at":"2026-08-29T06:19:15.720Z","tags":[{"paper_doi":"10.1093/cid/ciag438","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1093/cid/ciag438","tag_type":"category","value":"Immunology","value_numeric":null},{"paper_doi":"10.1093/cid/ciag438","tag_type":"category","value":"Infectious Diseases","value_numeric":null},{"paper_doi":"10.1093/cid/ciag438","tag_type":"condition","value":"Community-Acquired Pneumonia","value_numeric":null},{"paper_doi":"10.1093/cid/ciag438","tag_type":"condition","value":"Hospital-Acquired Pneumonia","value_numeric":null},{"paper_doi":"10.1093/cid/ciag438","tag_type":"condition","value":"Sepsis","value_numeric":null},{"paper_doi":"10.1093/cid/ciag438","tag_type":"condition","value":"Septic Shock","value_numeric":null},{"paper_doi":"10.1093/cid/ciag438","tag_type":"generic","value":"vancomycin","value_numeric":null},{"paper_doi":"10.1093/cid/ciag438","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1093/cid/ciag438","tag_type":"level_of_evidence","value":"6","value_numeric":null},{"paper_doi":"10.1093/cid/ciag438","tag_type":"modality","value":"Antimicrobial Stewardship","value_numeric":null},{"paper_doi":"10.1093/cid/ciag438","tag_type":"modality","value":"Beta-Lactam Antibiotic","value_numeric":null},{"paper_doi":"10.1093/cid/ciag438","tag_type":"modality","value":"Clinical Decision Support","value_numeric":null},{"paper_doi":"10.1093/cid/ciag438","tag_type":"modality","value":"Corticosteroid","value_numeric":null},{"paper_doi":"10.1093/cid/ciag438","tag_type":"modality","value":"Multiplex Nucleic Acid Amplification Test","value_numeric":null},{"paper_doi":"10.1093/cid/ciag438","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1093/cid/ciag438","tag_type":"study_design","value":"Multisociety Consensus Position Paper","value_numeric":null},{"paper_doi":"10.1093/cid/ciag438","tag_type":"warning","value":"Several highlighted diagnostic strategies are described as emerging and not yet validated for widespread use — clinicians should interpret those recommendations cautiously.","value_numeric":null},{"paper_doi":"10.1093/cid/ciag438","tag_type":"warning","value":"The paper covers pediatric and adult populations (PIDS is a co-society), but population-specific breakdowns are not detailed in the abstract.","value_numeric":null},{"paper_doi":"10.1093/cid/ciag438","tag_type":"warning","value":"This is a consensus position paper, not a systematic review or RCT; recommendations reflect expert opinion and evidence synthesis, not new primary data. Level of evidence assigned accordingly.","value_numeric":null}],"summaries":{"what_studied":"A multidisciplinary, multisociety expert panel (IDSA, ACEP, ASM, PIDS, SCCM, SHEA, SHM, SIDP) developed consensus-based, evidence-informed recommendations for hospital-based sepsis improvement across 6 domains: diagnostic testing, antimicrobial management, surveillance/metrics, adjunctive therapy, program infrastructure, and infection prevention.","key_result":"The panel produced actionable recommendations including: multiplex NAAT for positive blood cultures with stewardship support; optimized workflows for antibiotic delivery in septic shock; clinical decision support to prioritize β-lactam before vancomycin; defaulting antipseudomonal β-lactams to prolonged infusion in critically ill patients; EHR-based sepsis surveillance; corticosteroid protocols for severe CAP; and daily tooth brushing to prevent hospital-acquired pneumonia.","limitations":"Recommendations are consensus-based rather than derived from new primary trial data, limiting the strength of evidence. Emerging diagnostic strategies highlighted by the panel still require further validation before widespread adoption.","practice_takeaway":"Hospitals should implement multiplex blood culture diagnostics paired with active stewardship, default antipseudomonal β-lactams to prolonged infusion in the ICU, and use EHR-based surveillance to track empiric therapy adequacy and de-escalation rates. Standardizing daily oral care and source control protocols are low-cost, high-impact steps to reduce hospital-acquired and sepsis-related complications."}},{"doi":"10.1016/j.chest.2026.05.003","pmid":"42575632","title":"Predicting Outcomes in Community-Acquired Pneumonia","journal_title":"CHEST","journal_issn":"0012-3692","published_at":"2026-08-10T00:00:00.000Z","url":"https://doi.org/10.1016/j.chest.2026.05.003","source_score":3,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-17T13:33:10.632Z","updated_at":"2026-08-20T06:47:55.595Z","tags":[{"paper_doi":"10.1016/j.chest.2026.05.003","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.chest.2026.05.003","tag_type":"category","value":"Respiratory System","value_numeric":null},{"paper_doi":"10.1016/j.chest.2026.05.003","tag_type":"condition","value":"Community-Acquired Pneumonia","value_numeric":null},{"paper_doi":"10.1016/j.chest.2026.05.003","tag_type":"condition","value":"Severe Community-Acquired Pneumonia","value_numeric":null},{"paper_doi":"10.1016/j.chest.2026.05.003","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.chest.2026.05.003","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.1016/j.chest.2026.05.003","tag_type":"modality","value":"Biomarker","value_numeric":null},{"paper_doi":"10.1016/j.chest.2026.05.003","tag_type":"modality","value":"Complete Blood Count","value_numeric":null},{"paper_doi":"10.1016/j.chest.2026.05.003","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.chest.2026.05.003","tag_type":"study_design","value":"Editorial","value_numeric":null},{"paper_doi":"10.1016/j.chest.2026.05.003","tag_type":"warning","value":"Impact flag 'practice_changing' reflects the editorial's strong clinical argument, but authors themselves note that prospective multicenter confirmation is still needed.","value_numeric":null},{"paper_doi":"10.1016/j.chest.2026.05.003","tag_type":"warning","value":"The CAPNETZ cohort data is from the linked primary article (Weckler et al.) and not fully extractable from this publisher page alone.","value_numeric":null},{"paper_doi":"10.1016/j.chest.2026.05.003","tag_type":"warning","value":"The paper metadata provided contains only the title, DOI, journal, and publication date — no abstract, methods, results, or full text were included. All summary fields and most tags have been left null or omitted because no content could be verified from the source. Please provide the full text or abstract for a complete extraction.","value_numeric":null},{"paper_doi":"10.1016/j.chest.2026.05.003","tag_type":"warning","value":"The paper metadata provided contains only the title, DOI, journal, and publication date — no abstract, methods, results, or full text were included. All summary fields and tags have been left unpopulated because no content could be verified from the source. Please provide the full text or abstract to enable structured extraction.","value_numeric":null},{"paper_doi":"10.1016/j.chest.2026.05.003","tag_type":"warning","value":"This is an editorial (not a primary study); its key results are drawn from multiple referenced studies with different eosinopenia thresholds (≤10 vs ≤50 cells/μL), limiting direct cross-study comparison.","value_numeric":null}],"summaries":{"what_studied":"This editorial reviews evidence on admission eosinopenia (≤10 cells/μL) as a predictor of outcomes in hospitalized patients with community-acquired pneumonia (CAP), commenting on a linked multicenter prospective study (Weckler et al, CAPNETZ cohort) and synthesizing findings from related studies.","key_result":"Admission eosinopenia (≤10 cells/μL) was independently associated with ICU admission, need for mechanical ventilation, and longer hospital stay in CAP; it did not predict 30-day mortality in the general CAP cohort (overall mortality ~9%), but in severe CAP (ICU-admitted patients, n=496), eosinopenia (≤50 cells/μL) was an independent predictor of 30-day death (HR 1.95; 95% CI 1.19–3.20; P=.0008). Combined eosinopenia and lymphopenia showed additive predictive value for resource utilization.","limitations":"This is an editorial, not a primary study — conclusions are synthesized from multiple studies with differing eosinopenia thresholds (≤10 vs ≤50 cells/μL), making direct comparisons difficult. The relatively low overall mortality in the CAPNETZ cohort (~9%) may limit detection of a mortality signal. Authors call for prospective multicenter trials to confirm these findings.","practice_takeaway":"Check a simple blood count eosinophil level at admission in CAP patients — eosinopenia (≤10 cells/μL) flags higher risk of ICU admission and mechanical ventilation and can guide resource planning. Rising eosinophil counts during recovery may signal clinical improvement, consistent with the concept of 'dawn of well-being.'"}},{"doi":"10.1093/ofid/ofag499","pmid":"42592041","title":"Coccidioidomycosis Testing Among Patients Hospitalized With Community-Acquired Pneumonia","journal_title":"Open Forum Infectious Diseases","journal_issn":"2328-8957","published_at":"2026-08-05T00:00:00.000Z","url":"https://doi.org/10.1093/ofid/ofag499","source_score":11,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-14T13:24:58.742Z","updated_at":"2026-08-14T13:24:58.742Z","tags":[{"paper_doi":"10.1093/ofid/ofag499","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag499","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag499","tag_type":"category","value":"Infectious Diseases","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag499","tag_type":"condition","value":"Coccidioidomycosis","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag499","tag_type":"condition","value":"Community-Acquired Pneumonia","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag499","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag499","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag499","tag_type":"modality","value":"Fungal Serologic Testing","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag499","tag_type":"sample_size","value":"n=1141","value_numeric":1141},{"paper_doi":"10.1093/ofid/ofag499","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag499","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag499","tag_type":"warning","value":"Median eosinophil counts in the text are likely reported in units of 10^3/µL (i.e., 0.17 × 10^3 = 170/µL), consistent with the study eosinophilia threshold of 480/µL — unit labeling in the source text is ambiguous.","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag499","tag_type":"warning","value":"The detailed chart review subgroup (n=467) differs from the full cohort (n=1141); symptom associations and LOS findings apply only to the subgroup.","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag499","tag_type":"warning","value":"The 'practice_changing' impact flag is applied because the study advocates universal inpatient CAP testing for Coccidioides in endemic regions, but this is based on single-center observational data and should be interpreted cautiously pending broader validation.","value_numeric":null}],"summaries":{"what_studied":"This retrospective study evaluated the rate, temporal trends, and predictors of *Coccidioides* testing and positivity among 1,141 adults hospitalized for community-acquired pneumonia (CAP) at a tertiary care center in Maricopa County, Arizona (November 2024–October 2025), with detailed chart review of 467 patients admitted May–October 2025.","key_result":"Of 1,141 patients with CAP, 865 (75.8%) were tested for coccidioidomycosis; 85 (9.8%) tested positive. *Coccidioides* was the **most commonly identified CAP pathogen** in the cohort. Testing was more likely with fever, dyspnea, fatigue, or concerning radiographs. Positive results were more common in patients with night sweats, rash, headache, or eosinophilia (median eosinophil count 0.17 vs 0.04 ×10³/µL; P<.001). One-third of confirmed coccidioidomycosis cases had a co-detected second pathogen. Patients testing positive had shorter LOS than those testing negative (OR 1.36, 95% CI 1.02–1.81).","limitations":"- Single tertiary care center with a predominantly older, White population, limiting generalizability.\n- Retrospective, observational design prevents causal inference.\n- Patient identification relied on admission text search for 'pneumonia,' potentially missing cases identified post-admission.","practice_takeaway":"In endemic regions like Arizona, *Coccidioides* is the leading identifiable CAP pathogen among hospitalized patients — yet ~1 in 4 were not tested, likely missing 25–30 cases. Clinicians should test **all** hospitalized CAP patients in endemic areas for coccidioidomycosis, and a positive *Coccidioides* result should not preclude evaluation for bacterial or viral co-infection."}},{"doi":"10.1111/1742-6723.70299","pmid":"42366166","title":"Low‐Value Blood Culture Use in Adult Emergency Department Patients: A Scoping Review","journal_title":"Emergency Medicine Australasia","journal_issn":"1742-6731","published_at":"2026-06-28T00:00:00.000Z","url":"https://doi.org/10.1111/1742-6723.70299","source_score":2,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-05T13:38:44.200Z","updated_at":"2026-07-05T13:38:44.200Z","tags":[{"paper_doi":"10.1111/1742-6723.70299","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70299","tag_type":"category","value":"Emergency Medicine","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70299","tag_type":"condition","value":"Bacteremia","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70299","tag_type":"condition","value":"Cellulitis","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70299","tag_type":"condition","value":"Community-Acquired Pneumonia","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70299","tag_type":"condition","value":"Sepsis","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70299","tag_type":"condition","value":"Urinary Tract Infection","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70299","tag_type":"generic","value":"procalcitonin","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70299","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70299","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70299","tag_type":"modality","value":"Blood Culture","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70299","tag_type":"modality","value":"Diagnostic Stewardship","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70299","tag_type":"sample_size","value":"n=18","value_numeric":18},{"paper_doi":"10.1111/1742-6723.70299","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70299","tag_type":"study_design","value":"Scoping Review","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70299","tag_type":"warning","value":"Level of evidence set to 3 (scoping review of observational studies); no RCTs were included in the review.","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70299","tag_type":"warning","value":"Prevalence range (19%–69%) is not directly comparable across studies due to heterogeneous, post-hoc definitions of 'low-value'—interpret with caution.","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70299","tag_type":"warning","value":"Sample size tag reflects the number of included studies (n=18), not individual patients; the largest single included study involved ~44,123 blood culture events. No single patient-level N is reported across all studies.","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70299","tag_type":"warning","value":"The CMS/JCAHO PN-3b mandate cited as a key driver was retired in 2014; its ongoing influence reflects historical rather than current policy context.","value_numeric":null}],"summaries":{"what_studied":"This scoping review mapped the literature on low-value blood culture (LVBC) use in adult ED patients, covering definitions, prevalence, drivers, and consequences across 18 studies (published 1998–2024, screened from 6 databases through June 2025).","key_result":"No study explicitly defined LVBCs; five proxy themes emerged. Prevalence of LVBCs ranged widely from 19% to 69%. Across 7,854 pooled BCs, only 223 (2.8%) directly changed antibiotic management. The top driver was pressure to comply with quality mandates (e.g., CMS/JCAHO PN-3b, 1-hour sepsis bundle). False positives equalled or exceeded true positives in several studies, leading to unnecessary antibiotics, extra testing, and longer stays. Estimated annual costs of LVBCs ranged from AUD $18,000 to USD $178,000 per 1,000 patients.","limitations":"- All 18 included studies were observational (mostly retrospective, single-centre), limiting generalisability.\n- No study formally evaluated patient-centred outcomes (e.g., discomfort, anxiety) or conducted prospective economic analysis.\n- Heterogeneous and post-hoc definitions of 'low-value' preclude direct comparison of prevalence estimates across studies.","practice_takeaway":"Routine blood cultures in ED patients with CAP, uncomplicated UTI, or non-septic presentations rarely change management and generate harmful false positives—consider risk-stratification tools (e.g., procalcitonin-based models, Modified Shapiro Rule) before ordering. Institutional mandates and reflexive ordering are key drivers to target through education and real-time decision support."}},{"doi":"10.1093/cid/ciag295","pmid":"42227019","title":"Swab Testing to Optimize Pneumonia Treatment With Empiric Vancomycin: A Randomized Controlled Trial","journal_title":"Clinical Infectious Diseases","journal_issn":"1058-4838","published_at":"2026-06-02T00:00:00.000Z","url":"https://doi.org/10.1093/cid/ciag295","source_score":15,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-11T13:43:04.306Z","updated_at":"2026-06-11T13:43:04.306Z","tags":[{"paper_doi":"10.1093/cid/ciag295","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1093/cid/ciag295","tag_type":"category","value":"Immunology","value_numeric":null},{"paper_doi":"10.1093/cid/ciag295","tag_type":"category","value":"Infectious Diseases","value_numeric":null},{"paper_doi":"10.1093/cid/ciag295","tag_type":"condition","value":"Community-Acquired Pneumonia","value_numeric":null},{"paper_doi":"10.1093/cid/ciag295","tag_type":"condition","value":"MRSA Infection","value_numeric":null},{"paper_doi":"10.1093/cid/ciag295","tag_type":"generic","value":"vancomycin","value_numeric":null},{"paper_doi":"10.1093/cid/ciag295","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1093/cid/ciag295","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1093/cid/ciag295","tag_type":"modality","value":"Antimicrobial Stewardship","value_numeric":null},{"paper_doi":"10.1093/cid/ciag295","tag_type":"modality","value":"Glycopeptide Antibiotic","value_numeric":null},{"paper_doi":"10.1093/cid/ciag295","tag_type":"modality","value":"Molecular Diagnostic (PCR)","value_numeric":null},{"paper_doi":"10.1093/cid/ciag295","tag_type":"sample_size","value":"n=277","value_numeric":277},{"paper_doi":"10.1093/cid/ciag295","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1093/cid/ciag295","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1093/cid/ciag295","tag_type":"warning","value":"30-day mortality results are mentioned in the abstract conclusion but no numerical data are provided in the available text — this endpoint should be interpreted cautiously.","value_numeric":null},{"paper_doi":"10.1093/cid/ciag295","tag_type":"warning","value":"Level of evidence assigned as 2 (single RCT); a multicenter replication would be needed to upgrade confidence.","value_numeric":null},{"paper_doi":"10.1093/cid/ciag295","tag_type":"warning","value":"The trial is single-center and non-blinded; the lack of effect may partly reflect site-specific prescriber culture rather than a true failure of the diagnostic strategy.","value_numeric":null}],"summaries":{"what_studied":"This single-center RCT (STOP-Vanc) randomized 277 adult ICU patients with suspected CAP 1:1 to usual care with or without MRSA nares PCR testing, evaluating whether swab-guided de-escalation reduced vancomycin use over 7 days.","key_result":"MRSA nasal PCR had a high NPV of 98.9%, yet vancomycin-free hours alive were nearly identical: 105.7 hours (control) vs. 109.7 hours (intervention), an adjusted difference of only 4 hours (95% CI, −9.5 to 18.2; P = .458). No difference in 30-day mortality was observed.","limitations":"- Single-center design limits generalizability.\n- Non-blinded trial; clinician behavior (e.g., ignoring negative swab results) may have attenuated the intervention's effect.\n- The study does not fully characterize *why* clinicians did not act on negative swab results, making it hard to design corrective interventions.","practice_takeaway":"A negative MRSA nares PCR is highly reliable (NPV ~99%) for ruling out MRSA CAP, but ordering the test alone does not change prescriber behavior in the ICU — active antimicrobial stewardship support is likely needed to translate a negative result into vancomycin discontinuation."}},{"doi":"10.1093/ofid/ofag253","pmid":null,"title":"Beta-Lactam plus Azithromycin or Doxycycline versus Fluoroquinolones in Hospitalized Adult Patients with Community-Acquired Pneumonia: A Systematic Review and Network Meta-Analysis","journal_title":"Open Forum Infectious Diseases","journal_issn":"2328-8957","published_at":"2026-05-01T00:00:00.000Z","url":"https://doi.org/10.1093/ofid/ofag253","source_score":10,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":false,"crossref":true,"unpaywall":true},"created_at":"2026-05-07T22:50:44.846Z","updated_at":"2026-05-07T22:50:44.846Z","tags":[{"paper_doi":"10.1093/ofid/ofag253","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag253","tag_type":"brand","value":"Avelox","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag253","tag_type":"brand","value":"Levaquin","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag253","tag_type":"brand","value":"Zithromax","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag253","tag_type":"category","value":"Infectious Diseases","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag253","tag_type":"condition","value":"Community-Acquired Pneumonia","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag253","tag_type":"generic","value":"azithromycin","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag253","tag_type":"generic","value":"doxycycline","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag253","tag_type":"generic","value":"levofloxacin","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag253","tag_type":"generic","value":"moxifloxacin","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag253","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag253","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag253","tag_type":"modality","value":"Beta-Lactam Antibiotic","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag253","tag_type":"modality","value":"Fluoroquinolone","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag253","tag_type":"modality","value":"Macrolide","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag253","tag_type":"modality","value":"Tetracycline","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag253","tag_type":"sample_size","value":"n=186,789","value_numeric":186789},{"paper_doi":"10.1093/ofid/ofag253","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag253","tag_type":"study_design","value":"Systematic Review and Network Meta-Analysis","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag253","tag_type":"warning","value":"GRADE certainty of evidence ratings for individual outcomes are not specified in the abstract; confidence in these findings may vary by outcome.","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag253","tag_type":"warning","value":"Network meta-analysis nodes included 4 regimens but the number of direct comparisons between each pair is uneven, which may affect precision of indirect estimates.","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag253","tag_type":"warning","value":"The total sample size combines a small RCT pool (n=861) with a large non-randomized pool (n=185,928); results are heavily weighted by observational data, which may limit causal inference.","value_numeric":null}],"summaries":{"key_result":"No statistically significant differences were found between beta-lactam + azithromycin and beta-lactam + doxycycline for in-hospital mortality, ICU admission, need for invasive mechanical ventilation, *C. difficile* infection, or QT prolongation — across both direct comparisons and network meta-analysis.","what_studied":"This systematic review and network meta-analysis compared beta-lactam + azithromycin vs. beta-lactam + doxycycline vs. fluoroquinolones (levofloxacin, moxifloxacin) for hospitalized adults with CAP, pooling 20 studies (6 RCTs, 14 non-randomized) across databases up to June 2024.","limitations":"- The 6 RCTs enrolled only 861 participants, limiting power for rare outcomes.\n- The 14 non-randomized studies (n=185,928) are subject to confounding and heterogeneity in patient populations.\n- No head-to-head RCTs directly comparing azithromycin vs. doxycycline as the add-on agent were identified.","practice_takeaway":"For hospitalized adults with CAP on a beta-lactam backbone, doxycycline appears to be an equally effective alternative to azithromycin with a similar safety profile — a useful option when azithromycin resistance or cardiac concerns arise. Clinicians can consider either agent with similar confidence until direct RCT data are available."}},{"doi":"10.1016/s1473-3099(26)00115-5","pmid":"42070554","title":"Real-world effectiveness of 20-valent pneumococcal conjugate vaccine against all-cause outcomes among Medicare beneficiaries aged 65 years and older in the USA: a retrospective cohort study","journal_title":"The Lancet Infectious Diseases","journal_issn":"1473-3099","published_at":"2026-04-30T00:00:00.000Z","url":"https://doi.org/10.1016/s1473-3099(26)00115-5","source_score":21,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-28T14:02:25.633Z","updated_at":"2026-07-28T14:02:25.633Z","tags":[{"paper_doi":"10.1016/s1473-3099(26)00115-5","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1016/s1473-3099(26)00115-5","tag_type":"brand","value":"Prevnar 20","value_numeric":null},{"paper_doi":"10.1016/s1473-3099(26)00115-5","tag_type":"category","value":"Infectious Diseases","value_numeric":null},{"paper_doi":"10.1016/s1473-3099(26)00115-5","tag_type":"condition","value":"Community-Acquired Pneumonia","value_numeric":null},{"paper_doi":"10.1016/s1473-3099(26)00115-5","tag_type":"condition","value":"Invasive Pneumococcal Disease","value_numeric":null},{"paper_doi":"10.1016/s1473-3099(26)00115-5","tag_type":"condition","value":"Lower Respiratory Tract Infection","value_numeric":null},{"paper_doi":"10.1016/s1473-3099(26)00115-5","tag_type":"condition","value":"Pneumococcal Pneumonia","value_numeric":null},{"paper_doi":"10.1016/s1473-3099(26)00115-5","tag_type":"generic","value":"pneumococcal 20-valent conjugate vaccine","value_numeric":null},{"paper_doi":"10.1016/s1473-3099(26)00115-5","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/s1473-3099(26)00115-5","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/s1473-3099(26)00115-5","tag_type":"modality","value":"Pneumococcal Conjugate Vaccine","value_numeric":null},{"paper_doi":"10.1016/s1473-3099(26)00115-5","tag_type":"sample_size","value":"n=16503552","value_numeric":16503552},{"paper_doi":"10.1016/s1473-3099(26)00115-5","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/s1473-3099(26)00115-5","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1016/s1473-3099(26)00115-5","tag_type":"warning","value":"Funded by Pfizer (PCV20 manufacturer) — sponsorship bias should be considered when interpreting effect sizes.","value_numeric":null},{"paper_doi":"10.1016/s1473-3099(26)00115-5","tag_type":"warning","value":"Immunocompromised individuals were overrepresented in the vaccinated group (24.0% vs 20.6%), which may have attenuated effectiveness estimates despite statistical adjustment.","value_numeric":null},{"paper_doi":"10.1016/s1473-3099(26)00115-5","tag_type":"warning","value":"This is the first post-licensure effectiveness study for PCV20; findings may not yet be replicated by independent groups.","value_numeric":null},{"paper_doi":"10.1016/s1473-3099(26)00115-5","tag_type":"warning","value":"Vaccine effectiveness estimates are against all-serotype outcomes, not PCV20-specific serotypes, which may underestimate true serotype-specific effectiveness.","value_numeric":null}],"summaries":{"what_studied":"Real-world effectiveness of PCV20 (20-valent pneumococcal conjugate vaccine) in Medicare beneficiaries aged ≥65 in the USA, followed from July 2022 to June 2024, against invasive pneumococcal disease (IPD), pneumococcal pneumonia, all-cause pneumonia, and lower respiratory tract infections (LRTIs), compared to unvaccinated individuals.","key_result":"Adjusted vaccine effectiveness was **25.6%** against all-cause IPD, **23.3%** against all pneumococcal pneumonia, **15.2%** against all-cause pneumonia, and **7.4%** against LRTI. Within the first year, absolute rate reductions were 12.0, 12.8, 758.0, and 636.1 cases per 100,000 person-years, respectively.","limitations":"- Observational design with potential residual confounding despite inverse probability weighting.\n- Outcomes identified by ICD-10 codes, not laboratory-confirmed serotyping, so serotype-specific effectiveness cannot be determined.\n- Pfizer-funded study, introducing potential sponsorship bias.","practice_takeaway":"PCV20 offers measurable real-world protection in adults ≥65, with the largest absolute benefit seen against all-cause pneumonia and LRTIs within the first year of vaccination. Clinicians can cite this data to support PCV20 recommendation in older adults, including immunocompromised patients."}},{"doi":"10.1016/j.chest.2026.03.018","pmid":"41933608","title":"Association Between Admission Eosinophil Count and Hospital Resource Use in Community-Acquired Pneumonia","journal_title":"CHEST","journal_issn":"0012-3692","published_at":"2026-03-31T00:00:00.000Z","url":"https://doi.org/10.1016/j.chest.2026.03.018","source_score":48,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-17T13:33:10.382Z","updated_at":"2026-08-17T13:33:10.382Z","tags":[{"paper_doi":"10.1016/j.chest.2026.03.018","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.chest.2026.03.018","tag_type":"category","value":"Respiratory System","value_numeric":null},{"paper_doi":"10.1016/j.chest.2026.03.018","tag_type":"condition","value":"Community-Acquired Pneumonia","value_numeric":null},{"paper_doi":"10.1016/j.chest.2026.03.018","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.chest.2026.03.018","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1016/j.chest.2026.03.018","tag_type":"modality","value":"Biomarker (Eosinophil Count)","value_numeric":null},{"paper_doi":"10.1016/j.chest.2026.03.018","tag_type":"sample_size","value":"n=1639","value_numeric":1639},{"paper_doi":"10.1016/j.chest.2026.03.018","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.chest.2026.03.018","tag_type":"study_design","value":"Prospective Cohort Study","value_numeric":null},{"paper_doi":"10.1016/j.chest.2026.03.018","tag_type":"warning","value":"Eosinophil counts may be confounded by glucocorticoid use; the authors performed subgroup analyses but full confounder adjustment details are not available in the abstract.","value_numeric":null},{"paper_doi":"10.1016/j.chest.2026.03.018","tag_type":"warning","value":"The impact_flag 'practice_changing' is applied cautiously — while the threshold is novel and clinically accessible, the study is observational and from a single country; independent validation is needed before routine adoption.","value_numeric":null},{"paper_doi":"10.1016/j.chest.2026.03.018","tag_type":"warning","value":"The paper's DOI publication date (2026-03-31) is in the future relative to some reference databases but aligns with today's date of August 17, 2026.","value_numeric":null}],"summaries":{"what_studied":"This prospective multicenter cohort study (CAPNETZ, Germany, 2017–present) evaluated whether admission blood eosinophil counts predict hospital resource use—ICU admission, mechanical ventilation, and length of stay—in 1,639 adults hospitalized with community-acquired pneumonia (CAP).","key_result":"Eosinopenia (≤10 cells/μL) at admission was linked to higher ICU admission (14.2% vs 8.5%; adjusted OR 1.78), more mechanical ventilation (9.1% vs 5.2%; adjusted OR 1.82), and longer stays (mean 10.2 vs 9.0 days; P=.013). The 10 cells/μL threshold was the optimal cutoff, and the association held whether or not patients received systemic glucocorticoids.","limitations":"- Single-country study (German university hospitals), limiting generalizability to other health systems or settings.\n- Observational design precludes causal inference; unmeasured confounders may influence results.\n- Eosinophil counts can be acutely suppressed by glucocorticoids, though subgroup analyses partially addressed this.","practice_takeaway":"A routine CBC differential at admission yielding eosinophils ≤10 cells/μL may flag CAP patients at higher risk for ICU-level care and prolonged hospitalization. Clinicians can use this low-cost threshold to inform early triage and resource planning, pending prospective validation."}},{"doi":"10.1097/qco.0000000000001182","pmid":"41518106","title":"Non-antimicrobial interventions in recovery from community-acquired pneumonia in adults","journal_title":"Current Opinion in Infectious Diseases","journal_issn":"0951-7375","published_at":"2026-01-10T00:00:00.000Z","url":"https://doi.org/10.1097/qco.0000000000001182","source_score":14,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-01-13","doi":"10.1097/qco.0000000000001182","days":"7","issn":"0951-7375","rank":"8","field":"Clinical Medicine","score":"14","category":"Infectious Diseases","categories":["Infectious Diseases"],"_categories":["Infectious Diseases"]},"pubmed":{"doi":"10.1097/QCO.0000000000001182","title":"Non-antimicrobial interventions in recovery from community-acquired pneumonia in adults.","journal":"Current opinion in infectious diseases","methods":"","results":"","abstract":"$30","keywords":["community-acquired pneumonia","interventions","outcomes","recovery"],"pubmed_id":"41518106","conclusions":"","publication_date":"2026-01-10T00:00:00"},"crossref":{"DOI":"10.1097/qco.0000000000001182","URL":"https://doi.org/10.1097/qco.0000000000001182","ISSN":["0951-7375","1473-6527"],"link":[{"URL":"https://journals.lww.com/10.1097/QCO.0000000000001182","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["Non-antimicrobial interventions in recovery from community-acquired pneumonia in adults"],"author":[{"given":"Louise","family":"Lansbury","sequence":"first","affiliation":[{"name":"Faculty of Medicine and Health Sciences, University of Nottingham"},{"name":"National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre"}]},{"given":"Tricia","family":"McKeever","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sciences, University of Nottingham"},{"name":"National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre"}]},{"given":"Wei Shen","family":"Lim","sequence":"additional","affiliation":[{"name":"National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre"},{"name":"Department of Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK"}]}],"issued":{"date-parts":[[2025,12,30]]},"member":"276","prefix":"10.1097","source":"Crossref","volume":null,"created":{"date-time":"2026-01-10T12:00:10Z","timestamp":1768046410000,"date-parts":[[2026,1,10]]},"indexed":{"date-time":"2026-01-10T16:43:14Z","timestamp":1768063394818,"date-parts":[[2026,1,10]]},"license":[{"URL":"http://creativecommons.org/licenses/by/4.0","start":{"date-time":"2025-12-30T00:00:00Z","timestamp":1767052800000,"date-parts":[[2025,12,30]]},"delay-in-days":0,"content-version":"unspecified"}],"subject":[],"abstract":"$31","language":"en","relation":{},"resource":{"primary":{"URL":"https://journals.lww.com/10.1097/QCO.0000000000001182"}},"subtitle":[],"deposited":{"date-time":"2026-01-10T12:00:16Z","timestamp":1768046416000,"date-parts":[[2026,1,10]]},"issn-type":[{"type":"print","value":"0951-7375"},{"type":"electronic","value":"1473-6527"}],"published":{"date-parts":[[2025,12,30]]},"publisher":"Ovid Technologies (Wolters Kluwer 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of recent evidence on non-antimicrobial adjunctive interventions for adults with community-acquired pneumonia, including physiotherapy/early mobilization, nutrition, discharge processes, care bundles, corticosteroids, antiplatelets, and statins.","key_result":"Respiratory physiotherapy and early mobilization lowered length of stay, dyspnea, and readmissions, with little evidence for a mortality effect. Discharge communication and patient education reduced readmissions and improved adherence and satisfaction, guideline care bundles reduced 30-day mortality without changing length of stay or 30-day readmissions, and in severe CAP, corticosteroids probably reduce short-term mortality (possibly longer-term mortality and length of stay), while antiplatelets and statins may also reduce short-term mortality.","limitations":"Evidence spans heterogeneous studies and populations; few trials address individual micronutrient supplements, and core outcomes and long-term follow-up are inconsistently assessed.","practice_takeaway":"For adults hospitalized with CAP, consider early mobilization/respiratory physiotherapy and strong discharge education to reduce readmissions and length of stay, and implement guideline-based care bundles. In severe CAP, adjunctive corticosteroids likely improve short-term survival; benefits of antiplatelets and statins are suggestive but less certain."}},{"doi":"10.1186/s12879-025-12408-x","pmid":"41457224","title":"Beta-lactam plus macrolide treatment versus beta-lactam monotherapy for community-acquired pneumonia: a propensity score analysis using data from a multicenter prospective cohort study","journal_title":"BMC Infectious Diseases","journal_issn":"1471-2334","published_at":"2025-12-29T00:00:00.000Z","url":"https://doi.org/10.1186/s12879-025-12408-x","source_score":45,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2025-12-29","doi":"10.1186/s12879-025-12408-x","days":"30","issn":"1471-2334","rank":"5","field":"Clinical Medicine","score":"45","category":"Infectious Diseases","categories":["Infectious Diseases"],"_categories":["Infectious Diseases"]},"pubmed":{"doi":"10.1186/s12879-025-12408-x","title":"Beta-lactam plus macrolide treatment versus beta-lactam monotherapy for community-acquired pneumonia: a propensity score analysis using data from a multicenter prospective cohort study.","journal":"BMC infectious diseases","methods":"","results":"","abstract":"","keywords":["Anti-bacterial agents","Beta-Lactams","Macrolides","Pneumonia","Propensity score"],"pubmed_id":"41457224","conclusions":"","publication_date":"2025-12-29T00:00:00"},"crossref":{"DOI":"10.1186/s12879-025-12408-x","URL":"https://doi.org/10.1186/s12879-025-12408-x","ISSN":["1471-2334"],"link":[{"URL":"https://link.springer.com/article/10.1186/s12879-025-12408-x","content-type":"text/html","content-version":"vor","intended-application":"text-mining"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["Beta-lactam plus macrolide treatment versus beta-lactam monotherapy for community-acquired pneumonia: a propensity score analysis using data from a multicenter prospective cohort study"],"author":[{"given":"Kei","family":"Nakashima","sequence":"first","affiliation":[]},{"given":"Masahiro","family":"Aoshima","sequence":"additional","affiliation":[]},{"given":"Hiroki","family":"Matusi","sequence":"additional","affiliation":[]},{"given":"Atsushi","family":"Shiraishi","sequence":"additional","affiliation":[]},{"given":"Hiroyuki","family":"Ito","sequence":"additional","affiliation":[]},{"given":"Motoi","family":"Suzuki","sequence":"additional","affiliation":[]},{"given":"Konosuke","family":"Morimoto","sequence":"additional","affiliation":[]},{"given":"Koya","family":"Ariyoshi","sequence":"additional","affiliation":[]},{"given":null,"family":null,"sequence":"additional","affiliation":[]}],"funder":[{"name":"The Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University received financial support from Pfizer for this study."}],"issued":{"date-parts":[[2025,12,29]]},"member":"297","prefix":"10.1186","source":"Crossref","volume":null,"created":{"date-time":"2025-12-29T03:54:44Z","timestamp":1766980484000,"date-parts":[[2025,12,29]]},"indexed":{"date-time":"2025-12-29T03:55:27Z","timestamp":1766980527423,"date-parts":[[2025,12,29]]},"license":[{"URL":"https://creativecommons.org/licenses/by/4.0","start":{"date-time":"2025-12-29T00:00:00Z","timestamp":1766966400000,"date-parts":[[2025,12,29]]},"delay-in-days":0,"content-version":"tdm"},{"URL":"https://creativecommons.org/licenses/by/4.0","start":{"date-time":"2025-12-29T00:00:00Z","timestamp":1766966400000,"date-parts":[[2025,12,29]]},"delay-in-days":0,"content-version":"am"}],"subject":[],"abstract":null,"language":"en","relation":{},"resource":{"primary":{"URL":"https://link.springer.com/10.1186/s12879-025-12408-x"}},"subtitle":[],"assertion":[{"name":"received","group":{"name":"ArticleHistory","label":"Article History"},"label":"Received","order":1,"value":"31 December 2024"},{"name":"accepted","group":{"name":"ArticleHistory","label":"Article History"},"label":"Accepted","order":2,"value":"16 December 2025"},{"name":"first_online","group":{"name":"ArticleHistory","label":"Article History"},"label":"First Online","order":3,"value":"29 December 2025"},{"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"},"order":1},{"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"},"order":2,"value":"The study received approval from the ethics review boards of the Institute of Tropical Medicine at Nagasaki University, Ebetsu City Hospital, Kameda Medical Center, Chikamori Hospital, and Juzenkai Hospital (registration no. 11063070). This study was conducted in accordance with the principles outlined in the Declaration of Helsinki. We obtained written informed consent from all conscious patients. In the cases of adults with cognitive decline, a legal guardian or an appropriate representative of these participants provided informed consent on their behalf. Given that the study was observational and involved no invasive interventions or deviations from standard medical treatment, all the institutional review boards waived the requirement for written informed consent for a few unconscious patients."},{"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"},"order":3,"value":"Not applicable."},{"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"},"order":4,"value":"K.M. received research funding support from Pfizer. 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