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Systematic review
Insufficient evidence to recommend routine adjunctive chest physiotherapy for adults with pneumonia
  1. Michalis Agrafiotis
  1. Intensive Care Unit, Thriassion General Hospital of Elefsis, Magoula, Greece
  1. Correspondence to Michalis Agrafiotis
    Gennimata Avenue, 19600, Magoula, Greece; m.agrafiotis{at}

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The cornerstone of pneumonia management remains the early administration of appropriate antimicrobial therapy. Adjunctive medical therapies (eg, corticosteroids and activated protein C) have also been considered for complementing the antimicrobial treatment of pneumonia; however, these therapies did not yield satisfactory or encouraging results1. Furthermore, another confounding issue, the role of chest physiotherapy in therapeutic procedures targeting pneumonia, has not been evaluated extensively.

Limited information from studies with limitations

This task was laudably undertaken by Yang and colleagues in the first systematic review and meta-analysis on this issue. They performed an extensive search in several databases (including Medline, Embase and Central) for trials comparing various types of physiotherapy to no physiotherapy for the management of pneumonia in adults. Both intubated and non-intubated patients were included. Mortality and “cure” rate were chosen as primary outcome measures; secondary measures included, among others, duration of hospital stay, fever, leukocytosis and …

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  • Competing interests None.