title: Quinolones for treatment of nosocomial pneumonia: a meta-analysis.
abstract: Although quinolones are often used to treat nosocomial pneumonia (NP), there have been few trials documenting their efficacy in treating NP. Given the growing use of quinolones and issues regarding resistance, we conducted a meta-analysis of all trials of quinolones for treatment of NP. We identified 5 randomized trials comparing quinolones with other agents used to treat NP. The studies varied in both quality and sample size and included a total of nearly 1200 subjects. Four of the 5 trials used ciprofloxacin, administered every 8 h, whereas the fifth used levofloxacin administered daily. In 3 trials, the comparator agent was imipenem-cilistatin, whereas, in 2 trials, ceftazadime was the comparator agent. The efficacy of quinolones and comparator antibiotics was similar, with a pooled odds ratio for clinical cure of 1.12 (95% confidence interval, 0.80-1.55). Neither microbiological eradication rates nor mortality rates varied on the basis of antimicrobial selection.
authors.affiliation: Pulmonary and Critical Care Medicine Service, Walter Reed Army Medical Center, Washington, DC 20307, USA. afshorr@dnamail.com
authors.forename: Andrew F
authors.initials: AF
authors.lastname: Shorr
authors.forename: Gregory B
authors.initials: GB
authors.lastname: Susla
authors.forename: Marin H
authors.initials: MH
authors.lastname: Kollef
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use*; D015377:Cilastatin / Q000627:therapeutic use; D002939:Ciprofloxacin / Q000627:therapeutic use; D003428:Cross Infection / Q000188:drug therapy*; D006801:Humans; D015378:Imipenem / Q000627:therapeutic use; D064704:Levofloxacin; D015201:Meta-Analysis as Topic; D015242:Ofloxacin / Q000627:therapeutic use; D018410:Pneumonia, Bacterial / Q000188:drug therapy*; D015363:Quinolones / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic
chemical_list: D000890:Anti-Infective Agents; D015363:Quinolones; D015377:Cilastatin; D002939:Ciprofloxacin; D064704:Levofloxacin; D015378:Imipenem; D015242:Ofloxacin