{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T15:27:13Z","timestamp":1767626833043,"version":"3.41.2"},"reference-count":76,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2017,11,9]],"date-time":"2017-11-09T00:00:00Z","timestamp":1510185600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Scope<\/jats:title><jats:p>To study the factors associated with mortality in hospitalized patients with community\u2010acquired pneumonia treated with monotherapy or combination therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>PubMed and Scopus were searched. Patients receiving macrolides, \u03b2\u2010lactams and fluoroquinolones, as monotherapy or in combination, were included. Meta\u2010analyses and meta\u2010regressions were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty studies were included. Overall, monotherapy was not associated with higher mortality than combination (RR 1.14, 95% CI 0.99\u20101.32, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> 84%). Monotherapy was associated with higher mortality than combination in North American and retrospective studies. \u03b2\u2010lactam monotherapy was associated with higher mortality than \u03b2\u2010lactam\/macrolide combination in the primary (1.32, 1.12\u20101.56, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> 85%) and most sensitivity analyses. There was no difference in mortality between fluoroquinolone monotherapy and \u03b2\u2010lactam\/macrolide combination (0.98, 0.78\u20101.23, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> 73%). In meta\u2010regressions, the moderators that could partially explain the observed statistical heterogeneity were the frequency of cancer patients (<jats:italic>P<\/jats:italic> = .03) and Pneumonia Severity Index score IV (<jats:italic>P<\/jats:italic> = .008).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Due to the considerable heterogeneity and inclusion of unadjusted data, it is difficult to recommend a specific antibiotic regimen over another. Specific antibiotic regimens, study design and the characteristics of the population under study seem to influence the reported outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eci.12845","type":"journal-article","created":{"date-parts":[[2017,10,13]],"date-time":"2017-10-13T07:55:04Z","timestamp":1507881304000},"source":"Crossref","is-referenced-by-count":8,"title":["The dilemma of monotherapy or combination therapy in community\u2010acquired pneumonia"],"prefix":"10.1111","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9959-2242","authenticated-orcid":false,"given":"Konstantinos Z.","family":"Vardakas","sequence":"first","affiliation":[{"name":"Alfa Institute of Biomedical Sciences (AIBS) Athens Greece"},{"name":"Department of Medicine Henry Dunant Hospital Center Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyriakos K.","family":"Trigkidis","sequence":"additional","affiliation":[{"name":"Alfa Institute of Biomedical Sciences (AIBS) 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