SynthesisBMC infectious diseases2017
Clinical failure with and without empiric atypical bacteria coverage in hospitalized adults with community-acquired pneumonia: a systematic review and meta-analysis.
Synthesis in BMC infectious diseases, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 43 citations in OpenAlex.
- Identifying the Best Initial Oral Antibiotics for Adults with Community-Acquired Pneumonia: A Network Meta-Analysis.Journal of general internal medicine · 2024Pooled it
- Comparison of initial empirical antibiotic regimens in severe community-acquired pneumonia: a network meta-analysis.BMC pulmonary medicine · 2025Article
- Effectiveness of Ampicillin-Sulbactam Versus Ceftriaxone for the Initial Treatment of Community-Acquired Pneumonia in Older Adults: A Target Trial Emulation Study.Open forum infectious diseases · 2025Article
- Candent issues in pneumonia. Reflections from the Fifth Annual Meeting of Spanish Experts 2023.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2024Review
- The role of empiric atypical antibiotic coverage in non-severe community-acquired pneumonia.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2024Review
- Atypical Pathogens in Adult Community-Acquired Pneumonia and Implications for Empiric Antibiotic Treatment: A Narrative Review.Microorganisms · 2022Review
- Seroprevalence of community-acquired atypical bacterial pneumonia among adult COVID-19 patients from a single center in Al Madinah Al Munawarah, Saudi Arabia: A retrospective cohort study.Saudi medical journal · 2022Article
- Effectiveness of Beta-Lactam plus Doxycycline for Patients Hospitalized with Community-Acquired Pneumonia.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Observational
- Appropriate prescribing of azithromycin for community-acquired pneumonia.Internal medicine journal · 2022Article
- The effect of erythromycin and clarithromycin versus azithromycin on serum valproate concentration.Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society · 2022Article
- Lefamulin in Patients with Community-Acquired Bacterial Pneumonia Caused by Atypical Respiratory Pathogens: Pooled Results from Two Phase 3 Trials.Antibiotics (Basel, Switzerland) · 2021Article
- Multivalent cations interactions with fluoroquinolones or tetracyclines: A cross-sectional study.Saudi journal of biological sciences · 2021Article
- An Elderly COVID-19 Patient with Community-AcquiredHealthcare (Basel, Switzerland) · 2021Article
- Efficacy of Empiric Antibiotic Coverage in Community-Acquired Pneumonia Associated with Each Atypical Bacteria: A Meta-Analysis.Journal of clinical medicine · 2021Article
- Pathophysiological Basis and Rationale for Early Outpatient Treatment of SARS-CoV-2 (COVID-19) Infection.The American journal of medicine · 2021Review
- Efficacy and Safety of Nemonoxacin in Outpatients with Community-Acquired Pneumonia.Infection and drug resistance · 2020Article
- 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
- Getting to know our pneumococcus.Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e TisilogiaArticle
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBoth typical and atypical bacteria can cause community-acquired pneumonia (CAP); however, the need for empiric atypical coverage remains controversial. Our objective was to evaluate the impact of antibiotic regimens with atypical coverage (a fluoroquinolone or combination of a macrolide/doxycycline with a β-lactam) to a regimen without atypical antibiotic coverage (β-lactam monotherapy) on rates of clinical failure (primary endpoint), mortality, bacteriologic failure, and adverse events, (secondary endpoints).
methodsWe searched the PubMed, EMBASE and Cochrane Library databases for relevant RCTs of hospitalized CAP adults. We estimated risk ratios (RRs) with 95% confidence intervals (CIs) using a fixed-effect model, but used a random-effects model if significant heterogeneity (I
resultsFive RCTs with a total of 2011 patients were retained. A statistically significant lower clinical failure rate was observed with empiric atypical coverage (RR, 0.851 [95% CI, 0.732-0.99; P = 0.037]; I
conclusionsEmpiric atypical coverage was associated with a significant reduction in clinical failure in hospitalized adults with CAP. Reduction in mortality, bacterial failure, diarrhea, and discontinuation due to adverse effects were not significantly different between groups, but all estimates favored atypical coverage. Our findings provide support for the current guidelines recommendations to include empiric atypical coverage.
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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.