Antibiotics for community-acquired pneumonia in adult outpatients

Pakhalé, Smita; Mulpuru, Sunita; Verheij, Theo; Kochen, Michael M.; Rohde, Gernot; Bjerre, Lise M.

doi:10.1002/14651858.cd002109.pub4

Cited by 63 publications

(46 citation statements)

References 117 publications

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“…In a subgroup analysis of mostly outpatients, there was no difference in mortality (relative risk [RR] 0.96; 95 % CI 0.53-1.72). Another systematic review and meta-analysis of RCTs in outpatients with CAP [45] was limited by trial number. However, macrolide therapy was not associated with increased clinical cure when compared to respiratory fluoroquinolones in any of the analyses.…”

Section: Outpatient Capmentioning

confidence: 99%

The Value of Macrolide-Based Regimens for Community-Acquired Pneumonia

McFarlane

Sligl

2015

Curr Infect Dis Rep

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Macrolide antimicrobials are commonly prescribed, specifically for the treatment of respiratory tract infections. Although still effective, the development of widespread macrolide resistance has limited their use. Aside from their antimicrobial effects, macrolides are also known to possess immune-modulatory properties which may confer a survival benefit in both acute and chronic inflammatory states. This review discusses the efficacy, potential mechanisms, and adverse effects of macrolide therapy specifically in community-acquired pneumonia in outpatients, hospitalized ward patients, and those requiring intensive care unit admission. Challenges for ongoing research in this field are discussed and treatment recommendations offered.

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Section: Outpatient Capmentioning

confidence: 99%

The Value of Macrolide-Based Regimens for Community-Acquired Pneumonia

McFarlane

Sligl

2015

Curr Infect Dis Rep

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“…CAP is an important lower respiratory tract disease and has been shown to have a yearly incidence between 5 and 11 cases per 1,000 adults as estimated by some population-based studies in the United States and Europe [12]. In the last two decades, C. pneumoniae has been recognized to play a role in the etiology of CAP worldwide.…”

Section: Introductionmentioning

confidence: 99%

Role of Chlamydia pneumoniae in community-acquired pneumonia in hospitalized Jordanian adults

Al-Aydie

Obeidat

Al-Younes

2016

J Infect Dev Ctries

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Introduction: This study investigated the role of Chlamydia pneumoniae in the etiology of community-acquired pneumonia (CAP) in Jordanian adults. Methodology: Eighty hospitalized CAP patients and 110 healthy adults were enrolled. Overall prevalences of C. pneumoniae IgG antibodies in sera and the rate of acute infection were estimated, using the microimmunofluorescence method (MIF), at titers of 1:16 and 1:512, respectively. Moreover, a nested polymerase chain reaction (PCR) was used to detect C. pneumoniae DNA in nasopharyngeal and blood Buffy coat samples. Results: Overall chlamydial IgG prevalence was higher in CAP cases than controls (70% versus 61.8%). Similarly, higher rate of acute infection was found in patients than in controls (16.3% versus 5.5%). By focusing on subjects testing positive at 1:16, acute infection was detectable in 23.2% of CAP cases, compared with 8.8% of seropositive controls. Chlamydial DNA was confirmed in 8.2% and 8.8% of nasopharyngeal specimens from controls and patients, respectively. Moreover, 10.9% and 7.5% of Buffy coats from controls and cases, respectively, were PCR-positive. When performances of both assays for detection of the pathogen were assessed, the sensitivities of MIF and PCR were low and comparable. However, MIF demonstrated higher specificity, positive predictive value, and negative predictive value than PCR. Conclusions: MIF-based data indicate that C. pneumoniae could be a potential causal agent of CAP in Jordan. This study may serve as a basis to elucidate the exact role C. pneumoniae and other co-infecting pathogens in the etiology of respiratory tract disease.

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“…The findings from our placebo-controlled study will compliment trials of head to head comparisons between antibiotic classes summarised in the Cochrane review of antibiotics for pneumonia in primary care [10].…”

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confidence: 75%