Oral versus parenteral antibiotic therapy in adult patients with community-acquired pneumonia: A systematic review and meta-analysis of randomized controlled trials
Abstract
OBJECTIVES
Antibiotic therapy is widely used for patients with community-acquired pneumonia (CAP), yet whether the efficacy of antibiotics differs based on the treatment mode remains unclear. This study aimed to summarize the evidence regarding the efficacy and safety of oral versus parenteral administration of antibiotic therapy for the treatment of patients with CAP.
METHODS
The databases of PubMed, EmBase, and the Cochrane Central Register of Controlled Trials were systematically searched for eligible randomized controlled trials (RCTs) from inception until December 11, 2021. The effectiveness of oral versus parenteral administration of antibiotic therapy was estimated using a random-effects model. Additional sensitivity, subgroup, and publication bias analyses were performed.
RESULTS
Of 912 identified articles, 12 RCTs involving 2,158 patients with CAP were included in our pooled analysis. Mostly included trials with low certainty and some concerns regarding risk of bias including lack of allocation concealment and blinding of participants and personnel. Overall, oral antibiotic therapy did not affect the incidence of clinical success at the end of treatment (relative risk [RR], 1.01; 95% confidence interval [CI], 0.98-1.05; P=0.417), clinical success at follow-up (RR, 1.02; 95% CI, 0.98-1.06; P=0.301), and adverse events (RR, 0.87; 95% CI, 0.56-1.35; P=0.527). Moreover, oral antibiotic therapy had a beneficial effect on the risk of all-cause mortality (RR, 0.58; 95% CI,…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 2,158 participants or records.
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