BACKGROUND: We endeavoured to accumulate and evaluate the available evidence regarding therapies that have been investigated as potential adjuncts to antimicrobials for the treatment of immunocompetent adult patients with bacterial community-acquired pneumonia (CAP). METHODS: PubMed, Cochrane Central Register of Controlled Trials and of Systematic Reviews, and bibliographies of relevant articles were searched. A meta-analysis was performed whenever applicable. RESULTS: Administration of corticosteroids in patients with severe CAP was associated with lower mortality compared with placebo (odds ratio 0.21, 95% confidence interval 0.05-0.83). There was no evidence suggesting a survival benefit by the administration of activated protein C, non-invasive mechanical ventilation, anticoagulants, immunoglobulin, granulocyte-colony-stimulating factor, statins, probiotics, chest physiotherapy, antiplatelet drugs, over-the-counter cough medications, beta(2)-agonists, inhaled nitric oxide and angiotensin-converting enzyme inhibitors in patients with CAP. CONCLUSIONS: This review outlines the potential usefulness of the numerous adjunctive therapies for CAP and underlines the need for further research in the field.
BACKGROUND: We endeavoured to accumulate and evaluate the available evidence regarding therapies that have been investigated as potential adjuncts to antimicrobials for the treatment of immunocompetent adult patients with bacterial community-acquired pneumonia (CAP). METHODS: PubMed, Cochrane Central Register of Controlled Trials and of Systematic Reviews, and bibliographies of relevant articles were searched. A meta-analysis was performed whenever applicable. RESULTS: Administration of corticosteroids in patients with severe CAP was associated with lower mortality compared with placebo (odds ratio 0.21, 95% confidence interval 0.05-0.83). There was no evidence suggesting a survival benefit by the administration of activated protein C, non-invasive mechanical ventilation, anticoagulants, immunoglobulin, granulocyte-colony-stimulating factor, statins, probiotics, chest physiotherapy, antiplatelet drugs, over-the-counter cough medications, beta(2)-agonists, inhaled nitric oxide and angiotensin-converting enzyme inhibitors in patients with CAP. CONCLUSIONS: This review outlines the potential usefulness of the numerous adjunctive therapies for CAP and underlines the need for further research in the field.
Authors: M Woodhead; F Blasi; S Ewig; J Garau; G Huchon; M Ieven; A Ortqvist; T Schaberg; A Torres; G van der Heijden; R Read; T J M Verheij Journal: Clin Microbiol Infect Date: 2011-11 Impact factor: 8.067
Authors: Konstantinos Z Vardakas; Ilias I Siempos; Alexandros Grammatikos; Zoe Athanassa; Ioanna P Korbila; Matthew E Falagas Journal: CMAJ Date: 2008-12-02 Impact factor: 8.262
Authors: Dheeraj Gupta; Ritesh Agarwal; Ashutosh Nath Aggarwal; Navneet Singh; Narayan Mishra; G C Khilnani; J K Samaria; S N Gaur; S K Jindal Journal: Lung India Date: 2012-07
Authors: Anna K Coussens; Robert J Wilkinson; Yasmeen Hanifa; Vladyslav Nikolayevskyy; Paul T Elkington; Kamrul Islam; Peter M Timms; Timothy R Venton; Graham H Bothamley; Geoffrey E Packe; Mathina Darmalingam; Robert N Davidson; Heather J Milburn; Lucy V Baker; Richard D Barker; Charles A Mein; Leena Bhaw-Rosun; Rosamond Nuamah; Douglas B Young; Francis A Drobniewski; Christopher J Griffiths; Adrian R Martineau Journal: Proc Natl Acad Sci U S A Date: 2012-09-04 Impact factor: 11.205