Observational studyCritical care (London, England)2026
Monotherapy versus combination therapy in severe Legionella pneumonia: a multicenter retrospective observational study.
Observational study in Critical care (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe incidence of Legionella pneumophila pneumonia is rising. Since 2012, French guidelines recommend fluoroquinolone monotherapy or combination therapy with a fluoroquinolone and macrolide for severe cases, without favoring a strategy. This study assessed the impact of antibiotic strategies on mortality in severe Legionella pneumophila pneumonia in ICU patients. MATERIALS AND
methodsWe conducted a retrospective, observational multicenter cohort study across ICUs at the university hospitals of Rouen, Caen, Amiens, Lille, and Elbeuf General Hospital, covering the period from January 1, 2017, to December 31, 2022. All adult patients admitted to ICUs for Legionella pneumophila were included. Patients were divided into two groups: monotherapy and combination therapy. The combination therapy group included those who received exclusive combination therapy and those who transitioned from monotherapy to combination therapy (non-exclusive combination therapy). The primary endpoint was 28-day mortality after ICU admission. Secondary outcomes included 90-day mortality, ventilation duration, ICU stay length, and antibiotic-related adverse events.
resultsWe included 93 patients: 13 in the monotherapy group and 80 in the combination therapy group, with 24 (30%) receiving non-exclusive and 56 (70%) exclusive combination therapy. In the monotherapy group, 12 patients (92.3%) received fluoroquinolones and 1 (7.7%) received a macrolide. Combination therapy consisted of fluoroquinolones and macrolides in all but one case, treated with fluoroquinolones and rifampicin. High-flow oxygen was required in 59 patients (69.4%), invasive ventilation in 65 patients (69.9%), and acute respiratory distress syndrome occurred in 64 patients (68.8%). The 28-day mortality was not significantly different between the two groups (15.4% vs. 12.5). No significant differences were observed in invasive ventilation duration (16.5 vs. 10 days), ICU stay length (12 vs. 11.5 days), or 90-day mortality (23.1% vs. 16.25%). Adverse events attributed to antibiotherapy were cutaneous rash (n = 7; 87.5%) and confusion (n = 1 ;12.5%) and were not significantly different between the two groups (0% vs. 10%).
conclusionOur study suggests that monotherapy, particularly with fluoroquinolones, may be an alternative to combination therapy in managing severe Legionella pneumophila pneumonia in the ICU. Prospective and randomized studies would be necessary to confirm these results and refine treatment recommendations.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.