Non-lytic antibiotic treatment in community-acquired pneumococcal pneumonia does not attenuate inflammation: the PRISTINE trial

Groeneveld, Geert H; van der Reyden, Tanny J; Joosten, Simone A; Bootsma, Hester J; Cobbaert, Christa M; de Vries, Jutte J C; Kuijper, Ed J; van Dissel, Jaap T

A weakness of our pilot trial is the small sample size; this is in line with the exploratory character of our study. As we anticipated that the LTA and biomarker responses induced by b-lactam treatment would be spread across a broad range, we included more patients with rifampicin added to b-lactam treatment than b-lactam treatment only and randomized at a 2:1 ratio. With only four patients with pneumococcal pneumonia treated with b-lactam therapy only, this assumption was imperfect and the small group hindered comparisons. For example, in the analyses of biomarkers for inflammation, at the start of treatment, the PCT value seemed higher in the b-lactam group, while those of CRP and MR-proADM were higher in the rifampicin group. Since only three samples (one sample was missing) were available in the b-lactam group, the interpretation of these findings is difficult.