519. Longer Length of Antibiotic Therapy for Community-Acquired Pneumonia and Risk of Clostridium difficile Infection

Abstract

Background. We previously observed a median 9.5 days length of antibiotic therapy (LOT) among patients with community-acquired pneumonia (CAP) requiring hospitalization (Clin Infect Dis. 2018;66:1333-41). Treatment guidelines for CAP, however, suggest LOT >7 days is rarely necessary. In this study, we evaluated the risk of Clostridium difficile infection (CDI) as a potential harm of longer LOT. Methods. This retrospective cohort study included Medicare beneficiaries with parts A, B, and D coverage hospitalized for uncomplicated CAP in 2012-2013 for 2-10 days, home discharge, and no hospitalizations 30 days before or 3 days after index hospitalization. The main exposure was total LOT, represented by the sum of estimated inpatient and observed outpatient LOT, and defined as ?longer? if >9.5 days and ?shorter? if