{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T17:41:41Z","timestamp":1792172501191,"version":"4.4.0"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:00:00Z","timestamp":1747353600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Doxycycline is a frequently used alternative treatment for community-acquired pneumonia (CAP) in hospitalized patients; however, the evidence base is limited. We aimed to compare outcomes in CAP patients treated with doxycycline or azithromycin in combination with beta-lactams.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We evaluated patients with CAP admitted to Mayo Clinic hospitals from May 2018 to September 2022 and treated with either azithromycin or doxycycline in combination with a beta-lactam. Patients who received both antibiotics or were on either antibiotic as chronic therapy prior to admission were excluded. The primary outcome was mortality. Patients were 1-to-1 matched according to the presence of congestive heart failure, coronary artery disease, chronic obstructive pulmonary disease, human immunodeficiency virus infection, recent immunosuppressant use, and pneumonia severity index class.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 8492 patients (5810 for azithromycin, 2682 for doxycycline), 2671 doxycycline-treated patients were matched with azithromycin-treated patients. In-hospital mortality was significantly lower in the azithromycin group than in the doxycycline group (odds ratio, 0.71; 95% confidence interval [CI], .56\u2013.9), as was 90-day mortality (hazard ratio, 0.83; 95% CI, .73\u2013.95). Patients on azithromycin also had significantly more hospital-free days (HFDs) than those on doxycycline (estimate, 1.37; 95% CI, .99\u20131.74).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among hospitalized patients with CAP, azithromycin was associated with lower mortality and more HFDs compared with doxycycline in combination with beta-lactams. Randomized, controlled trials are needed to assess the effectiveness of each regimen and to compare their potential side effects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciaf252","type":"journal-article","created":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T08:19:46Z","timestamp":1747297186000},"page":"639-647","source":"Crossref","is-referenced-by-count":5,"title":["Comparative Effectiveness of Azithromycin Versus Doxycycline in Hospitalized Patients With Community-Acquired Pneumonia Treated With Beta-Lactams: A Multicenter Matched Cohort Study"],"prefix":"10.1093","volume":"82","author":[{"given":"Yewande E","family":"Odeyemi","sequence":"first","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic , Rochester, Minnesota , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1891-2118","authenticated-orcid":false,"given":"Aysun","family":"Tekin","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic , Rochester, Minnesota , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caitlin C","family":"Schanz","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Mayo Clinic , Rochester, Minnesota , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5196-5505","authenticated-orcid":false,"given":"Diana J","family":"Schreier","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Mayo Clinic , Rochester, Minnesota , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin","family":"Cole","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences, Mayo Clinic , Rochester, Minnesota , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ognjen","family":"Gajic","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic , Rochester, Minnesota , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin F","family":"Barreto","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Mayo Clinic , Rochester, Minnesota , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,5,16]]},"reference":[{"key":"2026043013113994400_ciaf252-B1","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1097\/MLR.0b013e3181f38006","article-title":"Trends in mortality and medical spending in patients hospitalized for community-acquired pneumonia: 1993\u20132005","volume":"48","author":"Ruhnke","year":"2010","journal-title":"Med Care"},{"key":"2026043013113994400_ciaf252-B2","doi-asserted-by":"crossref","first-page":"567.e1","DOI":"10.1016\/j.cmi.2016.03.015","article-title":"Declining mortality among hospitalized patients with community-acquired pneumonia","volume":"22","author":"Simonetti","year":"2016","journal-title":"Clin Microbiol Infect"},{"issue":"Suppl 2","key":"2026043013113994400_ciaf252-B3","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1186\/cc4927","article-title":"Community-acquired pneumonia on the intensive care unit: secondary analysis of 17,869 cases in the ICNARC case mix programme database","volume":"10","author":"Woodhead","year":"2006","journal-title":"Crit Care"},{"key":"2026043013113994400_ciaf252-B4","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1038\/s41572-021-00259-0","article-title":"Pneumonia","volume":"7","author":"Torres","year":"2021","journal-title":"Nat Rev Dis Primers"},{"key":"2026043013113994400_ciaf252-B5","doi-asserted-by":"crossref","first-page":"e45","DOI":"10.1164\/rccm.201908-1581ST","article-title":"Diagnosis and treatment of adults with community-acquired pneumonia. 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