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Fluoroquinolones versus Β-Lactams Plus Macrolides for Community-acquired Pneumonia in Adults: A Meta-analysis of Randomised Controlled Trials

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Objective: Several randomized trials have been done to compare fluoroquinolones alone with the combination therapy of β-lactams plus macrolides for treating community-acquired pneumonia (CAP) in adults. However, the efficacy and safety between the two arms are still unclear.

Methods: We searched the PubMed, Embase, ScienceDirect and China National Knowledge Infrastructure (CNKI). Two reviewers independently extracted data and the mortality, treatment success and adverse events were compared between fluoroquinolones and β-lactams plus macrolides. RevMan 5.0 was used for statistical analysis.

Results: 11 randomized controlled trials were included in our meta-analysis. Mortality was not significantly different for fluoroquinolones vs. β-lactams plus macrolides (OR 1.29, 95% CI 0.73–2.27). Treatment success was higher with fluoroquinolones both in the intention-to-treat (ITT) population (OR 1.37, 95% CI 1.02–1.83) and the clinically evaluable population (OR 1.34, 95% CI 1.01–1.79). No difference was found between fluoroquinolones and β-lactams plus macrolides in microbiological treatment success (OR = 1.31, 95% CI 0.82-2.09). 

Conclusions: Our meta-analysis suggested that fluoroquinolones were more effective than β-lactams plus macrolides for the treatment of CAP and the safety of the two therapies were similar. 

05 Feb, 2015
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e-Published: 14 Oct, 2015


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