Grant: Project Grant

Pneumonia is an infection of the lungs usually caused by bacteria and/or viruses. Pneumonia is the most common cause for hospital admission in the world. Those infected with pneumonia can require oxygen to help their breathing, need life support with a breathing machine, and can even progress to death. Antibiotics are needed to prevent or reduce uncontrolled inflammation and to speed up recovery. There are many antibiotics that can treat pneumonia, each having unique benefits but also undesired effects. Yet the best possible antibiotic choice remains uncertain for most patients with pneumonia. The goal of this study is to establish whether one antibiotic strategy is better than others for certain groups of patients hospitalized with pneumonia (we will test commonly used antibiotics, either by themselves, or in combination). The goal is to find an antibiotic strategy that results in better survival, reduces the risk of needing an intensive care unit for life support, and accelerates time of recovery. The trial will monitor for tolerance of antibiotics, the impact on the body's natural flora (the "good" bacteria that live on and in the human body) and the risk of side effects, like infectious diarrhea or other hospital acquired complications. This study is a "pilot trial", meaning we will recruit 120 patients across 8 hospitals in Canada, to test the concept that we can safely and effectively run this trial on a larger scale. This information will influence and support the launch of a larger trial, enrolling thousands of patients in > 100 hospitals to conclusively answer this important question. The overall study design is unique, since the trial learns as it proceeds, observing which antibiotics are working better in specific groups. This will allow the trial to stop as quickly as possible once results are determined with a high degree of certainty. The results of this pilot trial and the larger study will impact the care of pneumonia patients around the world.