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Review: empirical atypical coverage does not reduce mortality in hospitalised patients with community acquired pneumonia

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 Q In hospitalised patients with community acquired pneumonia (CAP), does empirical antibiotic coverage of atypical pathogens reduce mortality and improve clinical efficacy?

Clinical impact ratings Internal medicine ★★★★★★☆ Geriatrics ★★★★★☆☆ Infectious disease ★★★★★★☆


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CENTRAL (Issue 4, 2004), Medline (to August 2004), EMBASE/Excerpta Medica (to July 2003), and reference lists of identified studies.

Embedded ImageStudy selection and assessment:

randomised controlled trials (RCTs) that compared an oral or intravenous antibiotic regimen with coverage of atypical pathogens (macrolides, fluoroquinolones, tetracycline, doxycycline, or chloramphenicol) with a regimen without such coverage for treatment of CAP in hospitalised adults. Studies with >30% dropout rate or involving mainly immune suppressed patients were excluded. Studies were assessed for quality of allocation generation and concealment, blinding, and intention to treat analysis. …

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  • For correspondence: Dr D Shefet, Rabin Medical Center, Petah-Tiqva, Israel. dshefet{at}

  • Source of funding: European Union Fifth Framework Information Society Technologies Program (TREAT).