{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T06:43:57Z","timestamp":1790664237699,"version":"4.1.0"},"reference-count":43,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2016,6,23]],"date-time":"2016-06-23T00:00:00Z","timestamp":1466640000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Respirology"],"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    It is unclear whether in the treatment of community\u2010acquired pneumonia (CAP) beta\u2010lactam plus macrolide antibiotics lead to better survival than beta\u2010lactam alone. We report a systematic review and meta\u2010analysis. Trials and observational studies published in English were included, if they provided sufficient data on odds ratio for all\u2010cause mortality for a beta\u2010lactam plus macrolide regimen compared with beta\u2010lactam alone. Two investigators independently searched for eligible articles. Of 514 articles screened, 14 were included: two open\u2010label randomized controlled trials (RCTs) comprising 1975 patients, one non\u2010RCT interventional study comprising 1011 patients and 11 observational studies comprising 33\u2009332 patients. Random\u2010model meta\u2010analysis yielded an odds ratio for all\u2010cause death for beta\u2010lactam plus macrolide compared with beta\u2010lactam alone of 0.80 (95% CI 0.69\u20130.92,\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.002) with substantial heterogeneity (\n                    <jats:italic>I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u200959%,\n                    <jats:italic>P<\/jats:italic>\n                    for heterogeneity\u2009=\u20090.002). Severity\u2010based subgroup analysis and meta\u2010regression revealed that adding macrolide had a favourable effect on mortality only for severe CAP. Of the two RCTs, one suggested that macrolide plus beta\u2010lactam lead to better outcome compared with beta\u2010lactam alone, while the other did not. Subgrouping based on study design, that is, RCT versus non\u2010RCT, which was almost identical to subgrouping based on severity, revealed substantial inter\u2010subgroup heterogeneity. Compared with beta\u2010lactam alone, beta\u2010lactam plus macrolide may decrease all\u2010cause death only for severe CAP. However, this conclusion is tentative because this was based mainly on observational studies.\n                  <\/jats:p>","DOI":"10.1111\/resp.12835","type":"journal-article","created":{"date-parts":[[2016,6,25]],"date-time":"2016-06-25T10:19:15Z","timestamp":1466849955000},"page":"1193-1200","source":"Crossref","is-referenced-by-count":57,"title":["Beta\u2010lactam plus macrolides or beta\u2010lactam alone for community\u2010acquired pneumonia: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"21","author":[{"given":"Nobuyuki","family":"Horita","sequence":"first","affiliation":[{"name":"Department of Pulmonology Yokohama City University Graduate School of Medicine  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuya","family":"Otsuka","sequence":"additional","affiliation":[{"name":"Department of Pulmonology Tohoku Rosai Hospital  Sendai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shusaku","family":"Haranaga","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Respiratory and Digestive Medicine, Faculty of Medicine University of the Ryukyus  Okinawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ho","family":"Namkoong","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Medicine, Department of Medicine Keio University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Miki","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine Japanese Red Cross Sendai Hospital  Sendai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoyuki","family":"Miyashita","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I Kawasaki Medical School  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Futoshi","family":"Higa","sequence":"additional","affiliation":[{"name":"National Hospital Organization Okinawa National Hospital  Okinawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine Saka General Hospital  Miyagi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Hemodialysis and Surgery, Chemotheraphy Research Institute International University of Health and Welfare  Ichikawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeru","family":"Kohno","sequence":"additional","affiliation":[{"name":"Department of Molecular Microbiology and Immunology Nagasaki University Graduate School of Biomedical Sciences  Nagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Kaneko","sequence":"additional","affiliation":[{"name":"Department of Pulmonology Yokohama City University Graduate School of Medicine  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,6,23]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1086\/511159"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD002109.pub4"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.159.21.2562"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.119.5.1420"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1086\/367541"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1155\/2004\/970828"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-005-1295-9"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-006-0183-2"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.06.00126004"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00031007"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1086\/591404"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00092607"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkp088"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2012-202296"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2014.4887"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1406330"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dku033"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.2012.02554.x"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.3656"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.15.2008"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199701233360402"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/thorax.58.5.377"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2009.133280"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2006.069740"},{"key":"e_1_2_8_26_1","unstructured":"WellsGA 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