{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T06:13:57Z","timestamp":1790835237894,"version":"4.1.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T00:00:00Z","timestamp":1765411200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Harvard Pilgrim Health Care Institute"},{"DOI":"10.13039\/100000030","name":"US Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["U54CK000611"],"award-info":[{"award-number":["U54CK000611"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"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>Newly released community-acquired pneumonia (CAP) guidelines include a conditional recommendation to treat all hospitalized patients with positive respiratory virus assays with antibacterials. We assessed the frequency, duration, and outcomes of antibacterial prescribing in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively identified all hospitalized patients with possible CAP and a positive respiratory virus test at 5 hospitals, June 2015\u2013December 2024. We used detailed clinical data to propensity-weight patients treated with 0\u20132 versus 5\u20137 days of antibacterials and compared outcomes overall and for different viruses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 6779 patients with possible CAP and a respiratory virus, 3269 were treated with 0\u20132 days and 1560 with 5\u20137 days of antibacterials. After propensity-weighting 2614 patients (1720 treated 0\u20132 days, 894 treated 5\u20137 days), there were no significant differences in hospital length of stay (11.7 days vs 11.1 days; OR 1.05, 95% CI .97\u20131.15), ICU admission after 48 hours (28.3% vs 28.2%; OR 1.01, 95% CI .86\u20131.18), in-hospital mortality (9.5% vs 9.8%; OR 0.97, 95% CI .74\u20131.27), or 30-day hospital-free days (16.9 days vs 17.0 days; OR 0.99, 95% CI .95\u20131.03). Results were consistent when restricted to non-SARS-CoV-2 viruses and to influenza alone, when comparing 0 versus 5\u20137 days of antibacterials, and when restricting to patients with ICD-10 codes for pneumonia present on admission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Antibacterial use for patients with possible CAP and respiratory viruses is highly variable but outcomes are similar with 0\u20132 versus 5\u20137 days of antibacterials. This suggests antibiotics are not beneficial in most CAP patients who test positive for respiratory viruses.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciaf687","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T13:17:48Z","timestamp":1765372668000},"page":"630-638","source":"Crossref","is-referenced-by-count":7,"title":["Associations Between Antibiotic Use and Outcomes in Patients Hospitalized With Community-Acquired Pneumonia and Positive Respiratory Viral Assays"],"prefix":"10.1093","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7630-3807","authenticated-orcid":false,"given":"Brett","family":"Biebelberg","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania 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University Medical Center , Amsterdam, The \u00a0","place":["Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8316-1496","authenticated-orcid":false,"given":"Claire","family":"Shappell","sequence":"additional","affiliation":[{"name":"Department of Medicine, Brigham and Women's Hospital , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9537-4245","authenticated-orcid":false,"given":"Chanu","family":"Rhee","sequence":"additional","affiliation":[{"name":"Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute , Boston, Massachusetts ,","place":["USA"]},{"name":"Department of Medicine, Brigham and Women's Hospital , Boston, Massachusetts 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