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.
Chen C, Wang C, Lai C. Antimicrobial Therapy and Respiratory Hospitalization or Death in Adults With Idiopathic Pulmonary Fibrosis. JAMA. 2021;326(11):1070–1071. doi:10.1001/jama.2021.11810
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