SynthesisClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021
Are Fluoroquinolones or Macrolides Better for Treating Legionella Pneumonia? A Systematic Review and Meta-analysis.
Synthesis in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers.
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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.
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Who cites it
29 citing papers in PubMed, 57 citations in OpenAlex.
- Proteome-Wide Reverse Vaccinology and Immunoinformatics-Guided Design of a Multi-Epitope Vaccine AgainstInternational journal of molecular sciences · 2026Article
- Monotherapy versus combination therapy in severe Legionella pneumonia: a multicenter retrospective observational study.Critical care (London, England) · 2026Observational
- Review
- Case Report: CavitaryFrontiers in medicine · 2026Article
- A case of severeRespiratory medicine case reports · 2026Article
- Submandibular infection in a healthy child caused by Legionella maceachernii.BMC infectious diseases · 2025Article
- Antimicrobial susceptibility of Legionella gormanii: species-specific ECOFFs, distinct MICs for rifampin versus Legionella pneumophila.Annals of clinical microbiology and antimicrobials · 2025Article
- Article
- A retrospective observational cohort study of oral azithromycin treatment for Legionnaires' disease.The Journal of antimicrobial chemotherapy · 2025Observational
- Analysis of ESAC-Net/EARS-Net Data from 29 EEA Countries for Spatiotemporal Associations Between Antimicrobial Use and Resistance-Implications for Antimicrobial Stewardship?Antibiotics (Basel, Switzerland) · 2025Article
- Design, Synthesis, andPharmaceuticals (Basel, Switzerland) · 2025Article
- Article
- Demonstration of cavitary legionnaires' pneumonia in a renal transplant recipient.Radiology case reports · 2025Article
- Case report: The value of early application of mNGS technology in the diagnosis and treatment of severe Legionnaires' disease: reports of two cases with different outcomes.Frontiers in medicine · 2025Article
- Severe Legionnaires' disease refractory to azithromycin: Are quinolones superior to macrolides?IDCases · 2025Article
- Legionella-induced suppurative cervical lymphadenitis in a child diagnosed by metagenomic next-generation sequencing: a case report.Frontiers in pediatrics · 2025Article
- Article
- Severe Legionnaires' disease.Annals of intensive care · 2024Review
- Characteristics ofAntimicrobial stewardship & healthcare epidemiology : ASHE · 2024Article
- Legionnaire's looms: Europe's wake-up call to enhance vigilance in detection and reporting.New microbes and new infections · 2023Article
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundThe Infectious Diseases Society of America recommends either a fluoroquinolone or a macrolide as a first-line antibiotic treatment for Legionella pneumonia, but it is unclear which antibiotic leads to optimal clinical outcomes. We compared the effectiveness of fluoroquinolone versus macrolide monotherapy in Legionella pneumonia using a systematic review and meta-analysis.
methodsWe conducted a systematic search of literature in PubMed, Cochrane, Scopus, and Web of Science from inception to 1 June 2019. Randomized controlled trials and observational studies comparing macrolide with fluoroquinolone monotherapy using clinical outcomes in patients with Legionella pneumonia were included. Twenty-one publications out of an initial 2073 unique records met the selection criteria. Following PRISMA guidelines, 2 reviewers participated in data extraction. The primary outcome was mortality. Secondary outcomes included clinical cure, time to apyrexia, length of hospital stay (LOS), and the occurrence of complications. The review and meta-analysis was registered with PROSPERO (CRD42019132901).
resultsTwenty-one publications with 3525 patients met inclusion criteria. The mean age of the population was 60.9 years and 67.2% were men. The mortality rate for patients treated with fluoroquinolones was 6.9% (104/1512) compared with 7.4% (133/1790) among those treated with macrolides. The pooled odds ratio assessing risk of mortality for patients treated with fluoroquinolones versus macrolides was 0.94 (95% confidence interval, .71-1.25, I2 = 0%, P = .661). Clinical cure, time to apyrexia, LOS, and the occurrence of complications did not differ for patients treated with fluoroquinolones versus macrolides.
conclusionsWe found no difference in the effectiveness of fluoroquinolones versus macrolides in reducing mortality among patients with Legionella pneumonia.
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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.