Antibacterial class is not obviously important in outpatient pneumonia: a meta-analysis

Guidelines for diagnosis and management of community-and hospital-acquired pneumonia in adults: Joint ICS/NCCP(I) recommendations

“…However, the need for empiric treatment of these organisms in mild CAP in the outpatient setting has been challenged as evidence suggests no benefit of covering these organisms with appropriate antibiotics in the outpatient setting. [90162163170176177] Combination therapy should be restricted to patients with severe pneumonia. [103120] Its advantages include expansion of the antimicrobial spectrum to include atypical pathogens and possibly immunomodulation.…”

Is Activity against “Atypical” Pathogens Necessary in the Treatment Protocols for Community‐Acquired Pneumonia? Issues with Combination Therapy

“…The review by Mills et al [38] showed similar resultsthat is, no improvement in clinical outcome with the use of antibiotics active against atypical pathogens, except among the subset of patients infected with L. pneumophila (table 2). The most recent report [37] reviewed studies from 1966 through July 2007 involving outpatients with CAP and concluded that there was no advantage to using specific antibacterials for treatment of mild CAP in otherwise healthy outpatients. A potential concern about these reports is that they tended to analyze the same studies.…”

“…On the basis of a literature review, there have been 3 metaanalyses performed to address this issue [36][37][38]. All 3 used the same study format with a review of comparative trials of agents showing activity against atypical pathogens (macrolides, fluoroquinolones, or tetracyclines) versus b-lactams.…”

Strategy of rational antibacterial therapy of acute exacerbation of chronic obstructive pulmonary disease: an approach based on minimal hazard risk

“…Однако значение этого феномена дискутабельно, более того, известно, что препараты, неактивные против атипичной микрофлоры (ингибиторзащи щенные аминопенициллины, цефалоспорины III по коления), эффективно элиминируя гемофильную инфекцию [34][35][36], быстро купируют обострение и обеспечивают более продолжительный период без обострений, чем, например, неактивные против ге мофильной палочки макролиды [34][35][36][37]. Эффектив ность β лактамов при атипичной инфекции, в част ности микоплазменной, отмечена в клинических исследованиях и метаанализах [38][39][40].…”