Martinez FJ, Yow E, Flaherty KR, et al. - Researchers undertook this pragmatic, randomized, unblinded clinical trial across 35 US sites in order to determine whether antimicrobial therapy in addition to usual care affords improved clinical results in patients suffering from idiopathic pulmonary fibrosis. They randomly assigned (1:1) 513 patients older than 40 years to receive antimicrobials (n = 254) or usual care alone (n = 259). Antimicrobials comprised co-trimoxazole (trimethoprim 160 mg/sulfamethoxazole 800 mg twice daily plus folic acid 5 mg daily, n = 128) or doxycycline (100 mg once daily if body weight <50 kg or 100 mg twice daily if ≥50 kg, n = 126). In the usual care alone group, no placebo was given. According to findings, no significant improvement in time to nonelective respiratory hospitalization or death was achieved by adding co-trimoxazole or doxycycline to usual care, vs usual care alone, in adults suffering from idiopathic pulmonary fibrosis. Thus, treatment using these antibiotics for the underlying disease is not supported.