ArticleEuropean journal of medical research2022
Doxycycline vs. macrolides in combination with a β-lactam antibiotic for the treatment of community-acquired pneumonia in inpatients.
Article in European journal of medical research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.
- Efficacy and safety of doxycycline for severe Mycoplasma pneumoniae pneumonia in pediatric patients.Clinical and experimental medicine · 2025Pooled it
- Beta-Lactam Plus Azithromycin or Doxycycline vs Fluoroquinolones in Adult Patients Hospitalized With Community-Acquired Pneumonia: A Systematic Review and Network Meta-analysis.Open forum infectious diseases · 2026Article
- Comparison of initial empirical antibiotic regimens in severe community-acquired pneumonia: a network meta-analysis.BMC pulmonary medicine · 2025Article
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHospitalized patients with non-severe community-acquired pneumonia (CAP) are treated with a β-lactam plus either a macrolide or doxycycline. Limited data exist on the effectiveness of the latter combination. Therefore, we aimed to compare the combination of doxycycline vs. macrolide when either is combined with a β-lactam from effectiveness and safety perspectives.
methodsThis was a retrospective cohort study in CAP inpatients between December 2013 and November 2020. Patients were divided into BL-D (β-lactam plus doxycycline) and BL-M (β-lactam plus a macrolide [azithromycin or clarithromycin]) groups. The primary endpoint was time to clinical stability. Secondary endpoints included length of stay (LOS) and in-hospital mortality.
resultsOf 197 patients included, 57 were in the BL-D arm and 140 were in the BL-M arm. Patients were similar at baseline, except for the presence of leukocytosis, risk factors for drug resistance, and duration of therapy (P < 0.05 for all comparisons). No difference in clinical cure rate was observed (94.7% vs. 91.4%; P = 0.43). Time to clinical stability and LOS were similar in both groups at 4 (P = 0.82) and 7 days (P = 0.62), respectively. While only three patients died, only one (from the BL-M group) was due to sepsis. Liver enzymes elevation was more prominent in the BL-M group (21.4% vs. 5.3%; P = 0.01). A subgroup analysis showed shorter time to clinical stability with clarithromycin but higher cure rates with azithromycin.
conclusionsData on doxycycline use with a β-lactam are scarce. Our study showed that such regimen was comparable in effectiveness to regimens involving macrolides with a better safety profile.
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