AI Article Synopsis
- The study aimed to evaluate the impact of treatment methods on mortality in hospitalized patients with community-acquired pneumonia, focusing on monotherapy and combination therapy.
- Out of 50 studies reviewed, results indicated that monotherapy did not lead to higher mortality compared to combination therapy overall, though certain demographics showed different trends, particularly in North America.
- Due to significant variation in the data and factors like patient cancer rates and pneumonia severity, it's challenging to definitively recommend one antibiotic treatment over another.
Article Abstract
Scope: To study the factors associated with mortality in hospitalized patients with community-acquired pneumonia treated with monotherapy or combination therapy.
Methods: PubMed and Scopus were searched. Patients receiving macrolides, β-lactams and fluoroquinolones, as monotherapy or in combination, were included. Meta-analyses and meta-regressions were performed.
Results: Fifty studies were included. Overall, monotherapy was not associated with higher mortality than combination (RR 1.14, 95% CI 0.99-1.32, I 84%). Monotherapy was associated with higher mortality than combination in North American and retrospective studies. β-lactam monotherapy was associated with higher mortality than β-lactam/macrolide combination in the primary (1.32, 1.12-1.56, I 85%) and most sensitivity analyses. There was no difference in mortality between fluoroquinolone monotherapy and β-lactam/macrolide combination (0.98, 0.78-1.23, I 73%). In meta-regressions, the moderators that could partially explain the observed statistical heterogeneity were the frequency of cancer patients (P = .03) and Pneumonia Severity Index score IV (P = .008).
Conclusion: Due to the considerable heterogeneity and inclusion of unadjusted data, it is difficult to recommend a specific antibiotic regimen over another. Specific antibiotic regimens, study design and the characteristics of the population under study seem to influence the reported outcomes.
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| http://dx.doi.org/10.1111/eci.12845 | DOI Listing |
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