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

http://dx.doi.org/10.1136/ebm.11.3.74

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    Shefet D, Robenshtok E, Paul M, et al. Empirical atypical coverage for inpatients with community-acquired pneumonia: systematic review of randomized controlled trials. Arch Intern Med 2005;165:1992–2000.
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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 ★★★★★★☆

    METHODS

    Embedded ImageData sources:

    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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    Footnotes

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

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