Atypical antibiotics alone seem no better for mortality and clinical efficacy than typical antibiotics alone in patients with community acquired pneumonia

Added March 19, 2020

Citation: Eliakim-Raz N, Robenshtok E, Shefet D, et al. Empiric antibiotic coverage of atypical pathogens for community-acquired pneumonia in hospitalized adults. Cochrane Database of Systematic Reviews 2012; (9): CD004418. 

What is this?  Some patients with COVID-19 will develop pneumonia and evidence from studies of the treatment of community acquired pneumonia (CAP) may be of help in treating such patients. CAP is a serious lung infection, usually treated with antibiotics. Two types of bacteria cause CAP: ‘typical’ and ‘atypical’, each requiring a different type of antibiotic, but initial treatment of CAP is usually empirical, using a drug that covers both typical and atypical bacteria.

In this Cochrane systematic review, the authors searched for randomized or quasi-randomized trials comparing antibiotic regimens containing atypical antibiotics versus those that had typical coverage only. They did not restrict by language of publication and did their searches in April 2012. They included 28 studies (5939 patients).

What works: Nothing noted.

What doesn’t work: For the regimens tested, no advantage was found for using an atypical antibiotic alone compared to using a typical antibiotic alone, on mortality and clinical efficacy, for patients with community acquired pneumonia.

What’s uncertain: The effects of adding an atypical antibiotic to a typical antibiotic (compared to using a typical antibiotic alone) for patients with community acquired pneumonia is uncertain.


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