Empiric antibiotics for community-acquired pneumonia in adult patients: a systematic review and a network meta-analysis

Analysis (27 RCTs) found cetaroline 600mg BD and piperacillin 2000mg BD had the highest probability of being the best (HPBB) for cure; ceftriaxone 2000mg OD plus levofloxacin 500mg BD, ertapenem 1000mg BD and amikacin 250 mg BD plus clarithromycin 500 mg BD had HPBB for mortality

SPS commentary:

NICE published guidance on the treatment of community-acquired pneumonia in September 2019 (NG138), which includes recommendations on antibiotic choice depending on clinical severity. When choosing an antibiotic, there are a number of factors to consider, including risk of complications, local antimicrobial resistance and surveillance data, recent antibiotic use and microbiological results. The guidance recommends oral antibiotics be used if the person can take medicines orally and the severity of their condition does not require IV antibiotics.

The guideline committee reviewed the available evidence in detail when forming their recommendations; details of this evidence (including numerous systematic reviews) can be found on its website.

Thorax

Resource links:

NICE guideline

NICE – summary of the evidence