Short Duration Treatment of Non-severe Community Acquired Pneumonia

A Non-Inferiority, Multicentered, Controlled, Randomized, Double Blinded Study Investigating the Antibiotic Treatment Duration (3-day Versus 8-day) for Subjects Admitted to Emergency Services With Acute Non-severe Community Acquired Pneumonia (CAP)

To investigate the non inferiority of a short lasting antibiotic treatment (3 days) when compared to a long lasting antibiotic treatment (8 days), at Day 15 after the beginning of treatment in terms of clinical efficacy, in adults admitted to emergency services for a non severe Community Acquired Pneumonia (PAC), who responded well to 3 days of beta-lactamin treatment (3GC or A/AC).

Inclusion Criteria:

• Subject must be 18 years old or over.
• admitted three days before for Community Acquired Pneumonia (CAP) defined by at least one clinical sign of pneumonia (dyspnea, cough, mucopurulent sputum, crackling sound on lungs) associated with a temperature >38°C on admission, and a new infiltrate consistent with pneumonia on chest x-ray, who responded favorably to 3 days of treatment with β-lactams (third generation injectable cephalosporin or amoxicillin-clavulanate)
• able to take oral medication.
• has given its informed consent.

Exclusion Criteria:

• Creatinin < 30ml/min
• History of jaundice / hepatic impairment associated with amoxicillin / clavulanic acid
• History of hypersensitivity to beta-lactam
• Presence of complications or severity of pneumonia (abscess , significant pleural effusion, severe chronic respiratory failure , septic shock, respiratory condition requiring the passage resuscitation).
• Known immunocompromised terrain ( asplenia , neutropenia, agammaglobulinemia , immunosuppressants, graft corticosteroids , myeloma , lymphoma, known HIV , sickle cell anemia , CHILD C cirrhosis).
• Antibiotic treatment exceeding 24 hours prior admission.
• Suspected atypical bacteria requiring combined antibiotics therapy .(Subjects who received a single dose of macrolides or fluoroquinolones emergency will not be excluded) .
• Legionella suspected on clinical, biological and radiological criteria .
• Subjects with clinical or epidemiological environment leading to suspect a healthcare-associated pneumonia with antibiotic resistant pathogen.
• Suspicion of pneumonia by aspiration.
• Intercurrent infection requiring antibiotic treatment.
• Pregnant women .
• Breastfeeding .
• Allergy to antibiotics in use.
• Life expectancy <1 month .
• Subject without health insurance.
• Subjects without home adress