NArrow compared to broad-Spectrum antibiotics for treatment of Community-Acquired Pneumonia – the NASCAP study

The aim is to optimally design a non-inferiority randomized clinical trial (RCT) that compares empirical narrow-spectrum with broad-spectrum beta-lactam antibiotic treatment of non-severe community-acquired pneumonia (CAP) in hospitalized patients.

To inform trial design, we will conduct a national observational pilot-study of CAP patients to assess treatment practices and patient outcomes, and to identify potential hurdles and solutions for recruitment in a future clinical trial. CAP is the most common infectious cause of hospitalization with 27000 patients being treated in Sweden each year.

Today, CAP guideline recommendations of treatment with narrow-spectrum antibiotics are based on expert opinion, and the trial will provide evidence for treatment guidelines and antimicrobial stewardship which can reduce antibiotic resistance.

The project consists of three work-packages: 1) pilot study to improve knowledge about CAP management and outcomes that inform important parameters to optimally design the RCT; 2) pilot study to improve site capacity to execute the RCT, and identification of patient representatives; 3) designing of the RCT protocol.

The studies will be performed at approx. 20 hospitals in Sweden.

The project is conducted by national and international experts supported by the ACTION Sweden trial network, the national working group on management of CAP in Sweden, and Kliniska Studier Sverige.