SynthesisCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2008
Respiratory fluoroquinolones for the treatment of community-acquired pneumonia: a meta-analysis of randomized controlled trials.
Synthesis in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 29 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 5 syntheses or guidelines pooled it, 102 citations in OpenAlex.
- Contact Lens Associated Bacterial Keratitis: Common Organisms, Antibiotic Therapy, and Global Resistance Trends: A Systematic Review.Frontiers in ophthalmology · 2021Pooled it
- Respiratory Fluoroquinolones Monotherapy vs. β-Lactams With or Without Macrolides for Hospitalized Community-Acquired Pneumonia Patients: A Meta-Analysis.Frontiers in pharmacology · 2019Pooled it
- Short-course versus long-course therapy of the same antibiotic for community-acquired pneumonia in adolescent and adult outpatients.The Cochrane database of systematic reviews · 2018Pooled it
- JAID/JSC Guidelines for the Treatment of Respiratory Infectious Diseases: The Japanese Association for Infectious Diseases/Japanese Society of Chemotherapy - The JAID/JSC Guide to Clinical Management of Infectious Disease/Guideline-preparing Committee Respiratory Infectious Disease WG.Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy · 2016Guideline
- Guidelines for the management of adult lower respiratory tract infections--full version.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2011Guideline
- High-dose levofloxacin in community-acquired pneumonia: a randomized, open-label study.Clinical drug investigation · 2012Trial
- Resistance to Lefamulin: An Evaluation of Data from In Vitro Antimicrobial Susceptibility Studies.Antibiotics (Basel, Switzerland) · 2026Review
- Comparative Safety of Empirical Antibiotic Classes in Newly Hospitalized COVID-19 Patients.Pharmaceuticals (Basel, Switzerland) · 2025Article
- Magic bullets, magic shields, and antimicrobials in between.Pharmaceutical science advances · 2023Review
- Antibiotic resistance ofFrontiers in public health · 2023Article
- Association between initiation of fluoroquinolones and hospital admission or emergency department visit for suicidality: population based cohort study.BMJ (Clinical research ed.) · 2022Article
- The Efficacy of Penicillins with β-lactamase Inhibitor or Cefmetazole against Pneumonia in which ESBL-Producing Bacteria were Isolated from Sputum.Infection & chemotherapy · 2021Article
- Fluoroquinolone treatment as a protective factor for 10-day mortality in Streptococcus pneumoniae bacteremia in cancer patients.Scientific reports · 2021Article
- Antibiotic Treatment of Pulmonary Infections: An Umbrella Review and Evidence Map.Frontiers in pharmacology · 2021Review
- Development of Inhalable Nanostructured Lipid Carriers for Ciprofloxacin for Noncystic Fibrosis Bronchiectasis Treatment.International journal of nanomedicine · 2021Article
- The efficacy of high-dose penicillin G for pneumococcal pneumonia diagnosed based on initial comprehensive assessment at admission: an observational study.BMC research notes · 2018Observational
- Moxifloxacin monotherapy versus combination therapy in patients with severe community-acquired pneumonia evoked ARDS.BMC anesthesiology · 2017Article
- Ciprofloxacin Controlled-Solid Lipid Nanoparticles: Characterization, In Vitro Release, and Antibacterial Activity Assessment.BioMed research international · 2017Article
- Observational
- The Value of Macrolide-Based Regimens for Community-Acquired Pneumonia.Current infectious disease reports · 2015Article
Corrections and comments
- Commented on by
- Commented on by
- Erratum issued
Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWe investigated whether the use of respiratory fluoroquinolones was associated with better clinical outcomes compared with the use of macrolides and beta- lactams among adults with pneumonia.
methodsWe searched PubMed, Current Contents, Scopus, EMBASE, ClinicalTrials.gov and Cochrane with no language restrictions. Two reviewers independently extracted data from published trials that compared fluoroquinolones (levofloxacin, moxifloxacin, gemifloxacin) with macrolides or beta-lactams or both. A meta-analysis was performed with the clinical outcomes of mortality, treatment success and adverse outcomes.
resultsWe included 23 trials in our meta-analysis. There was no difference in mortality among patients who received fluoroquinolones or the comparator antibiotics (OR 0.85, 95% CI 0.65-1.12). Pneumonia resolved in more patients who received fluoroquinolones compared with the comparator antibiotics for the included outcomes in the intention-to-treat population (OR 1.17, 95% CI 1.00-1.36), clinically evaluable population (OR 1.26, 95% CI 1.06-1.50) and the microbiologically assessed population (OR 1.67, 95% CI 1.28-2.20). Fluoroquinolones were more effective than a combination of beta-lactam and macrolide (OR 1.39, 95% CI 1.02-1.90). They were also more effective for patients with severe pneumonia (OR 1.84, 95% CI 1.02-3.29), those who required admission to hospital (OR = 1.30, 95% CI 1.04-1.61) and those who required intravenous therapy (OR = 1.44, 15% CI 1.13-1.85). Fluoroquinolones were more effective than beta-lactam and macrolide in open-label trials (OR = 1.35, 95% CI 1.08-1.69) but not in blinded randomized controlled trials (OR = 1.13, 95% CI 0.85-1.50).
interpretationFluoroquinolones were associated with higher success of treatment for severe forms of pneumonia; however, a benefit in mortality was not evident. A randomized controlled trial that includes patients with severe pneumonia with or without bacteremia is needed.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.