Adequate Duration of Antibiotic Treatment in Community-acquired Pneumonia With High Risk Class and Adequate Initial Clinical Response
Adequate Duration of Antibiotic Treatment in Community-acquired Pneumonia With High Risk Class and Adequate Initial Clinical Response
Non-inferiority, multicenter, prospective double-blind, randomized clinical trial of two
 parallel groups. The randomization between the 2 study groups will be carried out according
 to a scheme generated by a computer program, in blocks of 6 and stratified by centers. The
 antibiotic treatment will be evaluated during 5 days compared to the usual antibiotic
 treatment for more than 7 days in patients with community-acquired pneumonia with a Pneumonia
 Severity Index IV-V severity score who present an adequate response in the first 4 days of
 hospital antibiotic treatment.
Inclusion Criteria:

 -  Patients of both sexes older than 18 years

 -  Hospitalized patients diagnosed with CAP: appearance of a new radiological infiltrate
 plus the presence of at least two of the following signs or symptoms: fever (> 38 °
 C), cough, expectoration, chest pain, dyspnea or tachypnea, and signs of occupation of
 the alveolar space.

 -  That they present a PSI score class IV or V.

 -  Patients who have received adequate antibiotic treatment according to clinical
 guidelines (SEPAR, ATS) ((1,8,19)) from the first hour of admission to the emergency
 room.

 -  Patients who reach clinical stability: temperature ≤37.2 ºC, heart rate ≤100 beats /
 min, respiratory rate ≤24 breaths / min, systolic blood pressure> 90 mmHg; oxygen
 saturation> 90%; or oxygen blood pressure> 60 mmHg (15) before the fourth day.

 -  Signature of informed consent.

 Exclusion Criteria:

 -  Immunosuppression: Co infection with HIV and presence of AIDS, treatment with
 neutropenic effect or have received immunosuppressive treatment for any reason.
 Patients that are in chronic use of corticosteroids as prednisone or its equivalent
 with > 10 mg / day for 14 days.

 -  Patients hospitalized in the previous 14 days.

 -  Patients with pleural effusion

 -  Suspected multiresistant germs of any cause.

 -  Hypersensitivity or alterations in the tendons associated with the fuoroquinolones.

 -  Pregnancy or lactation.