Lloyd M, et al. - Via a double-blind, stepped-wedge, cluster-randomized effectiveness trial of 816 subjects hospitalized with community-acquired pneumonia (a leading cause of hospitalization, mortality, and health care costs worldwide) conducted between August 1, 2016, and October 29, 2017, the researchers assessed the efficiency of a bundle of evidence-supported treatments under conditions of routine care. Among the intervention and control groups, an unadjusted geometric mean ratio of 0.95 was recognized for the variation in the length of stay (days). However, no notable variations were noted for the secondary outcomes of mortality and readmission, and the results persisted unchanged even following further adjustment for sex and age. Greater proportions of gastrointestinal bleeding in the intervention group in comparison with the controls was observed. Hence, no evidence of efficiency was concluded and it led to a greater incidence of gastrointestinal bleeding, ad exhibited by this bundled intervention that involved adjunctive corticosteroids. Moreover, when implemented in combination, the efficiency of individual interventions illustrated in clinical trials might not necessarily be translated into the effectiveness and could even end in net harm.