Evidence map›Paper›PMID 39551892›Full record

SynthesisEuropean journal of clinical pharmacology2025

Effectiveness of macrolides as add-on therapy to beta-lactams in community-acquired pneumonia: A meta-analysis of randomized controlled trials.

Vitória Martins Prizão, Otavio Cosendey Martins, Beatriz Austregésilo de Athayde de Hollanda Morais, Beatriz Ximenes Mendes, Maria Luiza Rodrigues Defante, Mariana de Moura Souza

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In one paragraph

Synthesis in European journal of clinical pharmacology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

Vitória Martins PrizãoDepartment of Medicine, State University of Maringá, Maringá, Paraná, Brazil. vitoriamprizao@gmail.com.ORCID http://orcid.org/0009-0000-7974-0068
Otavio Cosendey MartinsDepartment of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil.ORCID http://orcid.org/0000-0003-2237-2799
Beatriz Austregésilo de Athayde de Hollanda MoraisDepartment of Medicine, Cesmac University Center, Maceió, Alagoas, Brazil.ORCID http://orcid.org/0009-0009-7345-0751
Beatriz Ximenes MendesDepartment of Medicine, Christus University Center, Fortaleza, Ceará, Brazil.ORCID http://orcid.org/0009-0009-0788-130X
Maria Luiza Rodrigues DefanteDepartment of Medicine, Redentor University Center, Itaperuna, Rio de Janeiro, Brazil.ORCID http://orcid.org/0000-0003-0524-5616
Mariana de Moura SouzaDepartment of Medicine, Federal University of Paraná, Curitiba, Paraná, Brazil.ORCID http://orcid.org/0009-0002-4506-0472

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis study aims to evaluate whether adding macrolides (MAC) to beta-lactam (BL) monotherapy in the treatment of community-acquired pneumonia (CAP) offers clinical benefits that justify the potential disadvantages or side effects.

methodsWe systematically searched PubMed, Embase, and Cochrane for randomized controlled trials (RCTs) comparing BL monotherapy to combination therapy with BL and MAC for the in-hospital treatment of CAP. We pooled mean differences (MD) for continuous outcomes and risk ratio (RR) for binary outcomes, with 95% confidence intervals (CI).

resultsSix RCTs with 2661 participants (52% receiving combination therapy), revealed no significant difference in in-hospital mortality (RR 0.99; 95% CI 0.78 to 1.25; p = 0.94; I2 = 0%), 90-day mortality (RR 1.03; 95% CI 0.82 to 1.29; p = 0.83; I2 = 13%), or 30-day mortality (RR 0.90; 75% CI 0.63 to 1.29; p = 0.58; I2 = 54%). Additionally, no significant differences were observed in the length of hospital stay (MD 0.51; 95% CI - 0.50 to 1.51; p = 0.33; I2 = 63%) or respiratory insufficiency (RR 0.63; 95% CI 0.29 to 1.35; p = 0.24; I2 = 74%). However, combination therapy significantly improved the treatment success rate (RR 1.17; 95% CI 1.04 to 1.32; p = 0.009; I2 = 0%).

conclusionOur findings suggest that BL + MAC therapy should not be used in all cases of hospitalized patients with CAP. PROSPERO ID: CRD42024516383 - Data of registration: 03/03/2024.

Indexed as

Anti-Bacterial Agentsbeta-LactamsCommunity-Acquired InfectionsDrug Therapy, CombinationMacrolidesRandomized Controlled Trials as TopicHospital MortalityHumansLength of StayPneumoniaPneumonia, BacterialAnti-Bacterial Agentsbeta-LactamsMacrolidesAntibioticsBeta-lactamCommunity-acquiredMacrolidesPneumonia

Identifiers

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.