A RANDOMIZED CONTROLLED TRIAL OF FILGRASTIM AS AN ADJUNCT TO ANTIBIOTICS FOR TREATMENT OF HOSPITALIZED-PATIENTS WITH COMMUNITY-ACQUIRED PNEUMONIA

Because of the critical role of neutrophils in host defenses, it was h ypothesized that stimulation of neutrophil production and function wit h Filgrastim would improve the outcome of hospitalized patients with c ommunity-acquired pneumonia, To test this hypothesis, a randomized, pl acebo-controlled, multicenter trial of Filgrastim (300 mu g/day up to 10 days) as an adjunct to antibiotics was conducted for these patients . Outcome measures included time to resolution of morbidity (TRM, a co mposite measure of temperature, respiratory rate, blood oxygenation, a nd chest radiograph), 28-day mortality, length of stay, and adverse ev ents. Filgrastim increased blood neutrophils 3-fold, but TRM, mortalit y, and length of hospitalization were not affected, Treatment, however , accelerated radiologic improvement and appeared to reduce serious co mplications (e.g,, empyema, adult respiratory distress syndrome, and d isseminated intravascular coagulation). Filgrastim administration was safe and well tolerated in these patients. Additional trials are neede d to establish the value of this approach to treatment of infectious d iseases.