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Short-course versus prolonged-course antibiotic therapy for hospital-acquired pneumonia in critically ill adults

  1. Richard Pugh1,*,
  2. Chris Grant2,
  3. Richard PD Cooke3,
  4. Ged Dempsey2

Editorial Group: Cochrane Acute Respiratory Infections Group

Published Online: 5 OCT 2011

Assessed as up-to-date: 9 MAR 2011

DOI: 10.1002/14651858.CD007577.pub2


How to Cite

Pugh R, Grant C, Cooke RPD, Dempsey G. Short-course versus prolonged-course antibiotic therapy for hospital-acquired pneumonia in critically ill adults. Cochrane Database of Systematic Reviews 2011, Issue 10. Art. No.: CD007577. DOI: 10.1002/14651858.CD007577.pub2.

Author Information

  1. 1

    Glan Clwyd Hospital, Department of Anaesthetics, Rhyl, Denbighshire, UK

  2. 2

    University Hospital Aintree, Department of Critical Care, Liverpool, Merseyside, UK

  3. 3

    University Hospital Aintree, Department of Microbiology, Liverpool, Merseyside, UK

*Richard Pugh, Department of Anaesthetics, Glan Clwyd Hospital, Rhyl, Denbighshire, LL18 5UJ, UK. pughr@hotmail.com.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 5 OCT 2011

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This is not the most recent version of the article. View current version (24 AUG 2015)

[Figure 1]
Figure 1. 'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
[Figure 2]
Figure 2. 'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
[Analysis 1.1]
Analysis 1.1. Comparison 1 Short (fixed)-course antibiotic therapy versus prolonged-course antibiotic therapy for HAP, Outcome 1 28-day mortality.
[Analysis 1.2]
Analysis 1.2. Comparison 1 Short (fixed)-course antibiotic therapy versus prolonged-course antibiotic therapy for HAP, Outcome 2 Recurrence of pneumonia.
[Analysis 1.3]
Analysis 1.3. Comparison 1 Short (fixed)-course antibiotic therapy versus prolonged-course antibiotic therapy for HAP, Outcome 3 28-day antibiotic-free days.
[Analysis 1.4]
Analysis 1.4. Comparison 1 Short (fixed)-course antibiotic therapy versus prolonged-course antibiotic therapy for HAP, Outcome 4 ITU mortality.
[Analysis 1.5]
Analysis 1.5. Comparison 1 Short (fixed)-course antibiotic therapy versus prolonged-course antibiotic therapy for HAP, Outcome 5 Non-resolution of pneumonia.
[Analysis 1.6]
Analysis 1.6. Comparison 1 Short (fixed)-course antibiotic therapy versus prolonged-course antibiotic therapy for HAP, Outcome 6 In-hospital mortality.
[Analysis 1.7]
Analysis 1.7. Comparison 1 Short (fixed)-course antibiotic therapy versus prolonged-course antibiotic therapy for HAP, Outcome 7 Recurrence due to multi-resistant organism.
[Analysis 1.8]
Analysis 1.8. Comparison 1 Short (fixed)-course antibiotic therapy versus prolonged-course antibiotic therapy for HAP, Outcome 8 Duration of ITU stay.
[Analysis 1.9]
Analysis 1.9. Comparison 1 Short (fixed)-course antibiotic therapy versus prolonged-course antibiotic therapy for HAP, Outcome 9 Duration of hospital stay.
[Analysis 1.10]
Analysis 1.10. Comparison 1 Short (fixed)-course antibiotic therapy versus prolonged-course antibiotic therapy for HAP, Outcome 10 Duration of mechanical ventilation.
[Analysis 1.11]
Analysis 1.11. Comparison 1 Short (fixed)-course antibiotic therapy versus prolonged-course antibiotic therapy for HAP, Outcome 11 28-day mechanical ventilation-free days.
[Analysis 1.12]
Analysis 1.12. Comparison 1 Short (fixed)-course antibiotic therapy versus prolonged-course antibiotic therapy for HAP, Outcome 12 Mortality associated with VAP.
[Analysis 2.1]
Analysis 2.1. Comparison 2 Discontinuation of antibiotics according to Clinical Pulmonary Infection Score, Outcome 1 30-day mortality.
[Analysis 2.2]
Analysis 2.2. Comparison 2 Discontinuation of antibiotics according to Clinical Pulmonary Infection Score, Outcome 2 Episodes of superinfection or antimicrobial resistance.
[Analysis 2.3]
Analysis 2.3. Comparison 2 Discontinuation of antibiotics according to Clinical Pulmonary Infection Score, Outcome 3 Duration of antibiotic therapy.
[Analysis 2.4]
Analysis 2.4. Comparison 2 Discontinuation of antibiotics according to Clinical Pulmonary Infection Score, Outcome 4 Duration of ITU stay.
[Analysis 3.1]
Analysis 3.1. Comparison 3 Discontinuation of antibiotics according clinical guideline, Outcome 1 Recurrence of pneumonia.
[Analysis 3.2]
Analysis 3.2. Comparison 3 Discontinuation of antibiotics according clinical guideline, Outcome 2 Duration of antibiotic therapy.
[Analysis 3.3]
Analysis 3.3. Comparison 3 Discontinuation of antibiotics according clinical guideline, Outcome 3 In-hospital mortality.
[Analysis 3.4]
Analysis 3.4. Comparison 3 Discontinuation of antibiotics according clinical guideline, Outcome 4 Duration of ITU stay.
[Analysis 3.5]
Analysis 3.5. Comparison 3 Discontinuation of antibiotics according clinical guideline, Outcome 5 Duration of hospital stay.
[Analysis 3.6]
Analysis 3.6. Comparison 3 Discontinuation of antibiotics according clinical guideline, Outcome 6 Duration of mechanical ventilation.
[Analysis 4.1]
Analysis 4.1. Comparison 4 Discontinuation of antibiotic therapy according to serum procalcitonin level, Outcome 1 28-day mortality.
[Analysis 4.2]
Analysis 4.2. Comparison 4 Discontinuation of antibiotic therapy according to serum procalcitonin level, Outcome 2 Recurrence of pneumonia.
[Analysis 4.3]
Analysis 4.3. Comparison 4 Discontinuation of antibiotic therapy according to serum procalcitonin level, Outcome 3 28-day antibiotic-free days.
[Analysis 4.4]
Analysis 4.4. Comparison 4 Discontinuation of antibiotic therapy according to serum procalcitonin level, Outcome 4 Duration of antibiotic therapy.
[Analysis 4.5]
Analysis 4.5. Comparison 4 Discontinuation of antibiotic therapy according to serum procalcitonin level, Outcome 5 In-hospital mortality.
[Analysis 4.6]
Analysis 4.6. Comparison 4 Discontinuation of antibiotic therapy according to serum procalcitonin level, Outcome 6 ITU mortality.
[Analysis 4.7]
Analysis 4.7. Comparison 4 Discontinuation of antibiotic therapy according to serum procalcitonin level, Outcome 7 Non-resolution of pneumonia.
[Analysis 4.8]
Analysis 4.8. Comparison 4 Discontinuation of antibiotic therapy according to serum procalcitonin level, Outcome 8 Recurrence due to resistant organism.
[Analysis 4.9]
Analysis 4.9. Comparison 4 Discontinuation of antibiotic therapy according to serum procalcitonin level, Outcome 9 ITU duration of stay.
[Analysis 4.10]
Analysis 4.10. Comparison 4 Discontinuation of antibiotic therapy according to serum procalcitonin level, Outcome 10 Duration of hospital stay.
[Analysis 4.11]
Analysis 4.11. Comparison 4 Discontinuation of antibiotic therapy according to serum procalcitonin level, Outcome 11 Duration of mechanical ventilation.