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Comment & Response
September 21, 2021

Antimicrobial Therapy and Respiratory Hospitalization or Death in Adults With Idiopathic Pulmonary Fibrosis

Author Affiliations
  • 1Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan
  • 2Department of Internal Medicine, Cardinal Tien Hospital, New Taipei City, Taiwan
  • 3Department of Internal Medicine, Kaohsiung Veterans General Hospital Tainan Branch, Tainan, Taiwan
JAMA. 2021;326(11):1070-1071. doi:10.1001/jama.2021.11810

To the Editor Of the 513 patients with idiopathic pulmonary fibrosis (IPF) in the CleanUP-IPF trial,1 128 were randomized to receive co-trimoxazole; 126, doxycycline; and 259, usual care. After a mean follow-up of 13.1 months, there was no difference in the primary outcome (time to first nonelective respiratory hospitalization or all-cause mortality) between the groups. Based on this finding, the addition of co-trimoxazole or doxycycline to usual care was not recommended for patients with IPF. However, we have 2 concerns with this conclusion.

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