TITLE

Respiratory fluoroquinolones for the treatment of community-acquired pneumonia: a meta-analysis of randomized controlled trials

AUTHOR(S)
Vardakas, Konstantinos Z.; Siempos, Ilias I.; Grammatikos, Alexandros; Athanassa, Zoe; Korbila, Ioanna P.; Falagas, Matthew E.
PUB. DATE
December 2008
SOURCE
CMAJ: Canadian Medical Association Journal;12/2/2008, Vol. 179 Issue 12, p1269
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: We investigated whether the use of respiratory fluoroquinolones was associated with better clinical outcomes compared with the use of macrolides and β- lactams among adults with pneumonia. Methods: We searched PubMed, Current Contents, Scopus, EMBASE, ClinicalTrials.gov and Cochrane with no language restrictions. Two reviewers independently extracted data from published trials that compared fluoroquinolones (levofloxacin, moxifloxacin, gemifloxacin) with macrolides or β-lactams or both. A meta-analysis was performed with the clinical outcomes of mortality, treatment success and adverse outcomes. Results: We included 23 trials in our meta-analysis. There was no difference in mortality among patients who received fluoroquinolones or the comparator antibiotics (OR 0.85, 95% CI 0.65-1.12). Pneumonia resolved in more patients who received fluoroquinolones compared with the comparator antibiotics for the included outcomes in the intention-to-treat population (OR 1.17, 95% CI 1.00-1.36), clinically evaluable population (OR 1.26, 95% CI 1.06-1.50) and the microbiologically assessed population (OR 1.67, 95% CI 1.28-2.20). Fluoroquinolones were more effective than a combination of β-lactam and macrolide (OR 1.39, 95% CI 1.02-1.90). They were also more effective for patients with severe pneumonia (OR 1.84, 95% CI 1.02-3.29), those who required admission to hospital (OR = 1.30, 95% CI 1.04-1.61) and those who required intravenous therapy (OR = 1.44, 15% CI 1.13-1.85). Fluoroquinolones were more effective than β-lactam and macrolide in open-label trials (OR = 1.35, 95% CI 1.08-1.69) but not in blinded randomized controlled trials (OR = 1.13, 95% CI 0.85-1.50).
ACCESSION #
35415260

 

Related Articles

  • Early switch therapy from intravenous sulbactam/ampicillin to oral garenoxacin in patients with community-acquired pneumonia: a multicenter, randomized study in Japan. Kohno, Shigeru; Yanagihara, Katsunori; Yamamoto, Yoshihiro; Tokimatsu, Issei; Hiramatsu, Kazufumi; Higa, Futoshi; Tateyama, Masao; Fujita, Jiro; Kadota, Jun-ichi // Journal of Infection & Chemotherapy (Springer Science & Business;Dec2013, Vol. 19 Issue 6, p1035 

    The switch from intravenous to oral antibiotic therapy is recommended for treating hospitalized patients with community-acquired pneumonia (CAP). We performed a multicenter, randomized study to assess the benefit of switching from intravenous sulbactam/ampicillin (SBT/ABPC) to oral garenoxacin...

  • Early Switch to Oral Treatment in Patients with Moderate to Severe Community-Acquired Pneumonia: A Meta-Analysis. Athanassa, Zoe; Makris, Gregory; Dimopoulos, George; Falagas, Matthew E. // Drugs;2008, Vol. 68 Issue 17, p2469 

    Background: Early switch to oral antibacterials is recommended for the treatment of hospitalized patients with community-acquired pneumonia (CAP). However, its efficacy and safety in patients with more severe forms of CAP have not been well established. Objective: To evaluate early switch to...

  • Study conclusions should reflect results. Morris, Andrew M.; Vardakas, Konstantinos Z.; Siempos, Ilias I.; Falagas, Matthew E. // CMAJ: Canadian Medical Association Journal;3/31/2009, Vol. 180 Issue 7, p738 

    A letter to the editor in response to the article "Respiratory fluoroquinolones for the treatment of community-acquired pneumonia: a meta-analysis of randomized controlled trials," in the 2008 issue, as well as the authors' response is presented.

  • Preface. Johnson, Alan P.; Leibovici, Leonard // Journal of Antimicrobial Chemotherapy (JAC);Apr2011 Supplement 3, Vol. 66 Issue suppl_3, piii1 

    The article introduces a series of reports on the efficacy and safety of ceftaroline fosamil based on two randomized controlled trials of community-associated pneumonia (CAP), published within the issue.

  • Clinical and bacteriological efficacies of sitafloxacin against community-acquired pneumonia caused by Streptococcus pneumoniae: nested cohort within a multicenter clinical trial. Fujita, Jiro; Niki, Yoshihito; Kadota, Jun-ichi; Yanagihara, Katsunori; Kaku, Mitsuo; Watanabe, Akira; Aoki, Nobuki; Hori, Seiji; Tanigawara, Yusuke; Cash, Haley; Kohno, Shigeru // Journal of Infection & Chemotherapy (Springer Science & Business;Jun2013, Vol. 19 Issue 3, p472 

    We evaluated the clinical and bacteriological efficacy of oral sitafloxacin (STFX) in clinically diagnosed community-acquired pneumonia (CAP) caused by Streptococcus pneumoniae. Additionally, we cultured these patient samples to test the minimal inhibitory concentrations (MICs) of levofloxacin...

  • Levofloxacin reduces LOS and costs in CAP.  // PharmacoEconomics & Outcomes News;3/22/2008, Issue 549, p5 

    The article discusses research on the hospital length of stay (LOS) of patients with community-acquired pneumonia (CAP) being treated with levofloxacin. It references a study by J. Schein and colleagues published in the March 2008 issue of "Current Medical Research and Opinion." Inpatient...

  • Quinolones in Community-Acquired Pneumonia; Are They Born Equal? Wadi, Jamal Ahmad // International Arabic Journal of Antimicrobial Agents;2012, Vol. 2 Issue 3, p1 

    There has been debate on the best treatment regimen for CAP, whether to start treatment with β-lactams, β-lactam β-lactamase inhibitor, macrolides, a combination of the earlier or quinolones, among other less commonly used agents. In this review, an attempt to examine some data on the...

  • Empirical Therapy of Community-Acquired Pneumonia. Mandell, Lionel A.; Waterer, Grant W. // JAMA: Journal of the American Medical Association;7/28/2015, Vol. 314 Issue 4, p396 

    The article discusses a study by Nicolas Garin and colleagues, reported in "Journal of the American Medical Association (JAMA) Internal Medicine," of treatment options for community-acquired pneumonia (CAP). It outlines the study, a randomized trial which compared treatment with the antibiotic...

  • Prospective, randomised study to compare empirical treatment versus targeted treatment on the basis of the urine antigen results in hospitalised patients with community-acquired pneumonia. Falguera, M.; Ruiz-González, A.; A. Schoenenberger, J.; Touzón, C.; Gázquez, I.; Galindo, C.; M. Porcel, J. // Thorax;Feb2010, Vol. 65 Issue 2, p101 

    Background Recommendations for diagnostic testing in hospitalised patients with community-acquired pneumonia remain controversial. The aim of the present study was to evaluate the impact of a therapeutic strategy based on the microbiological results provided by urinary antigen tests for...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics