Adjunctive therapies for community-acquired pneumonia: a systematic review.
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.
Siempos
Ilias I
II
Alfa Institute of Biomedical Sciences (AIBS), Athens, Greece.
Vardakas
Konstantinos Z
KZ
Kopterides
Petros
P
Falagas
Matthew E
ME
D000328:Adult; D017714:Community-Acquired Infections / Q000188:drug therapy* / Q000401:mortality / Q000628:therapy*; D004359:Drug Therapy, Combination; D006801:Humans; D018410:Pneumonia, Bacterial / Q000188:drug therapy* / Q000401:mortality / Q000628:therapy*; D012121:Respiration, Artificial