Systemic Traditional Chinese Medicine in Multidrug-Resistant Bacterial Pneumonia

Multidrug-resistant bacterial pneumonia remains a major clinical challenge because of limited effective antimicrobial options, an increased risk of treatment failure and recurrent infection, and prolonged antimicrobial exposure. Traditional Chinese medicine (TCM) is commonly used as an adjunctive treatment in clinical practice in China; however, the association between systemic TCM treatment and the prognosis of patients with multidrug-resistant bacterial pneumonia has not been adequately evaluated in real-world settings.

This multicenter prospective observational cohort study will enroll hospitalized patients with multidrug-resistant bacterial pneumonia. The study is designed to evaluate the association between systemic TCM treatment received during routine clinical care and subsequent patient outcomes. Systemic TCM treatment is defined as physician-prescribed treatment with Chinese herbal decoctions, oral Chinese patent medicines, or Chinese medicine injections during hospitalization.

The study will not assign, mandate, or modify any clinical treatment. Decisions regarding antimicrobial therapy, supportive care, and TCM treatment will be made independently by the treating physicians according to the patient's clinical condition, routine clinical practice, and relevant clinical guidelines. Participants will be categorized according to whether they receive systemic TCM treatment during hospitalization, and outcomes will be compared between the exposed and unexposed groups.

This study is intended to generate real-world evidence regarding the potential role of systemic TCM treatment as an adjunct to routine clinical management in patients with multidrug-resistant bacterial pneumonia, particularly in relation to subsequent respiratory infection events, clinical recovery, antimicrobial exposure, and longer-term prognosis.

• Mortality [Срок оценки: At hospital discharge (up to 90 days after enrollment), and at 30, 90, and 180 days after hospital discharge.]
• Rehospitalization [Срок оценки: At 30, 90, and 180 days after discharge]
• Upper Respiratory Tract Infection Events [Срок оценки: From discharge to 180 days after discharge]
• Bacterial Clearance [Срок оценки: At discharge from the initial hospitalization or completion of antimicrobial therapy (up to 90 days after enrollment).]
• Clinical Cure [Срок оценки: At discharge from the initial hospitalization (up to 90 days after enrollment)]
• Antibiotic Treatment Days [Срок оценки: From enrollment through discontinuation of antibacterial therapy or hospital discharge, whichever occurs first (up to 90 days after enrollment).]
• Modified Community-Acquired Pneumonia Clinician-Reported Outcome Score [Срок оценки: At enrollment, discharge (up to 90 days after enrollment), and 30, 90, and 180 days after discharge]
• Modified Community-Acquired Pneumonia Patient-Reported Outcome Score [Срок оценки: At enrollment, discharge(up to 90 days after enrollment), and 30, 90, and 180 days after discharge]
• 36-Item Short Form Health Survey Score [Срок оценки: At enrollment, discharge (up to 90 days after enrollment), and 30, 90, and 180 days after discharge]