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Adjunctive therapies for community-acquired pneumonia: a systematic review Siempos II; Vardakas KZ; Kopterides P; Falagas MEJ Antimicrob Chemother 2008[Oct]; 62 (4): 661-8BACKGROUND: 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.|Adult[MESH]|Community-Acquired Infections/*drug therapy/mortality/*therapy[MESH]|Drug Therapy, Combination[MESH]|Humans[MESH]|Pneumonia, Bacterial/*drug therapy/mortality/*therapy[MESH]|Respiration, Artificial[MESH] |
