Evidence map›Paper›PMID 34751745›Full record

Observational studyClinical infectious diseases : an official publication of the Infectious Diseases Society of America2022

Effectiveness of Beta-Lactam plus Doxycycline for Patients Hospitalized with Community-Acquired Pneumonia.

Moe Uddin, Turab Mohammed, Mark Metersky, Antonio Anzueto, Carlos A Alvarez, Eric M Mortensen

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Article
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  5. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Moe UddinDepartment of Medicine, University of Connecticut School of Medicine, Farmington, Connecticut, USA.
Turab MohammedDepartment of Medicine, University of Connecticut School of Medicine, Farmington, Connecticut, USA.ORCID 0000-0001-5063-6419
Mark MeterskyDepartment of Medicine, University of Connecticut School of Medicine, Farmington, Connecticut, USA.ORCID 0000-0003-1968-1400
Antonio AnzuetoDepartment of Medicine, South Texas Veterans Health Care System, San Antonio, Texas, USA.
Carlos A AlvarezVA North Texas Health Care System, Dallas, Texas, USA.ORCID 0000-0002-9512-1870
Eric M MortensenDepartment of Medicine, University of Connecticut School of Medicine, Farmington, Connecticut, USA.ORCID 0000-0002-3880-5563

Funding

Impact of statins and ACE inhibitors on outcomes for pneumonia and sepsisR01NR010828 · NINR · UNIVERSITY OF TEXAS HLTH SCIENCE CENTER · PI MORTENSEN, ERIC M. · 2007 to 2009
$947k
NINR NIH HHS R01 NR010828
6 · The paper itself

Abstract

backgroundDespite clinical practice guideline recommendations to use doxycycline as part of combination therapy for some patients hospitalized with pneumonia, there is minimal evidence supporting this recommendation. Our aim was to examine the association between beta-lactam plus doxycycline and mortality for patients hospitalized with community-acquired pneumonia.

methodsWe identified patients >65 years of age admitted to any US Department of Veterans Affairs hospital in fiscal years 2002-2012 with a discharge diagnosis of pneumonia. We excluded those patients who did not receive antibiotic therapy concordant with the 2019 American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA) clinical practice guidelines. Using propensity score matching, we examined the association of doxycycline with 30- and 90-day mortality.

resultsOur overall cohort was comprised of 70533 patients and 5282 (7.49%) received doxycycline. Unadjusted 30-day mortality was 6.4% for those who received a beta-lactam plus doxycycline versus 9.1% in those who did not (P < .0001), and 90-day mortality was 13.8% for those who received a beta-lactam + doxycycline versus 16.8% for those who did not (P < .0001). In the propensity score matched models, both 30- (odds ratio 0.72, 95% confidence interval [CI], .63-.84) and 90-day (0.83, 95% CI, .74-.92) mortality were significantly lower for those who received doxycycline.

conclusionsIn this retrospective observational cohort study, we found that doxycycline use, as part of guideline-concordant antibiotic therapy, was associated with lower 30- and 90-day mortality than regimens without doxycycline. While this supports the safety and effectiveness of antibiotic regimes that include doxycycline, additional studies, especially randomized clinical trials, are needed to confirm this.

Indexed as

Community-Acquired InfectionsPneumoniaAnti-Bacterial Agentsbeta-LactamsDoxycyclineDrug Therapy, CombinationHumansRetrospective StudiesAnti-Bacterial Agentsbeta-LactamsDoxycyclineantimicrobial therapydoxycyclinelength of staymortalitypneumonia

Identifiers

PMID34751745
PMCPMC9402654

What OpenQuestion holds

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Registered trials

None linked

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.