Clarithromycin For Improved Clinical Outcomes in Community-Acquired Pneumonia: A Subgroup Analysis of the ACCESS Study

•ACCESS trial showed early anti-inflammatory effect of clarithromycin in hospitalized adults with CAP•Subgroups of patients differentiated by metrics were examined•The primary endpoint integrated respiratory symptoms, SOFA score and procalcitonin•Need for mechanical ventilation was analyzed•Benefit was found across all subgroups•Clarithromycin benefit was seen independent of the administration of corticosteroid use•Clarithromycin benefit was greater than corticosteroids benefit alone : In the ACCESS trial the addition of clarithromycin to standard-of-care (SoC) antibiotics enhanced early clinical response and attenuated the inflammatory burden in adults with community-acquired pneumonia (CAP) requiring hospitalization. A post-hoc analysis was performed to investigate the benefit in specific subgroups. The primary endpoint comprised two conditions to be met during the first 72 hours: ≥50% decrease of respiratory symptom severity score; and any of ≥30% decrease of SOFA score and favourable change of kinetics of procalcitonin (defined as ≥80% PCT decrease or PCT