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Table 1 Characteristics of Included Studies

From: Clinical failure with and without empiric atypical bacteria coverage in hospitalized adults with community-acquired pneumonia: a systematic review and meta-analysis

Study

Study Period; Publication Year

Design

Location

Funding Source

Enrolled Patientsa; ITT

Age (years)

PNA Characteristics

Antibiotic Regimena

Duration of Therapy (days)

Outcomes Definitions

Grain et al.

2009–2013; 2014

Non-inferiority open-label, RCT

6 sites in 1 country (Switzerland)

Non-industry

602; 580 (289 vs. 291)

76 (median)

Moderately severe PNA

BL (IV cefuroxime 1.5 G X 3/d or IV amoxicillin/ clavulanate 1.2 G X 4/d) vs BL + ML (IV/PO clarithromycin 500 mg X 2/d)

10

Mortality = 30-day. Failure = no clinical stability at day 7

Petitpretz et al.

1997–1998; 2001

Superiority, double-blind, RCT

82 sites in 20 countries (Europe, South America, Australia, Africa)

Non-industry

411; 408 (200 vs. 208)

51 (mean)

Mild-moderate PNA; suspected pneumococcal PNA; 79% hospitalized/21% outpatients

BL (PO amoxicillin 1 G X 3/d) vs FQ (PO moxifloxacin 400 mg X 1/d)

10

Mortality = during the study (38-day). Failure = no clinical/bacteriological response 3–5 days after end of therapy

Norrby et al.

Not reported; 1998

Superiority, open-label, RCT

64 sites in 13 countries (Europe, North and South America, Africa, Asia)

Industry

625; 619 (314 vs. 305)

65 (median)

Moderately severe PNA; excluded strongly suspected mycoplasma, chlamydia or legionella PNA; 94% CAP and 6% nosocomial PNA

BL (IV ceftriaxone 4 G X 1/d) vs FQ (IV levofloxacin 500 mg X 2/d, followed by PO levofloxacin 500 mg X 2/d)

8

Mortality = during the study (29-day). Failure = no clinical/bacteriological response 2–5 days after end of therapy

Leophonte et al.

1998–1999; 2004

Superiority, double-blind, RCT

102 sites in 3 countries (Europe, Africa)

Non-industry

324; 320 (167 vs. 153)

54 (mean)

Mild-moderate PNA; suspected pneumococcal PNA; 94% hospitalized

BL (PO amoxicillin/ clavulanate 1.2 G X 3/d) vs FQ (PO gemifloxacin 320 mg X 1/d)

7 for FQ; 10 for B-lactam

Mortality = during the study (30-day). Failure = no clinical/ bacteriological response at end of therapy

Kalbermatter et al.

1998; 2000

Superiority, open-label, RCT

1 site in 1 country (Argentina)

Non-industry

84; 84 (28 vs. 56)

60 (mean)

Mild-moderate PNA

BL (IV ceftriaxone 1 G X 2/d or IV amoxicillin/ clavulanate 1.2 G X 3/d) vs FQ (PO levofloxacin 500 mg X 2/d)

7–10 if favorable response

Failure = no clinical response at 72 h

  1. aatypical bacterial coverage arm vs non-atypical bacterial coverage arm. Abbreviations: PNA pneumonia, RCT randomized clinical trial, BL β-lactam, ML Macrolide, PO orally, IV intravenously, CAP community-acquired pneumonia