• Ying-Qi Zhang, Shui-Lan Zou, Hua Zhao, Ming-Ming Zhang, and Cai-Li Han.
• Department of Emergency Medicine, The First Hospital of Hebei Medical University, 89 Donggang Road, Shijiazhuang 050031, China. Electronic address: zhangyingqi08@sina.com.
• Am J Emerg Med. 2018 Oct 1; 36 (10): 1759-1765.

BackgroundThe goal of this study was to investigate whether ceftriaxone combination therapy is associated with better clinical outcomes than respiratory fluoroquinolone monotherapy for adults with community-acquired pneumonia (CAP). We conducted a meta-analysis of published studies.MethodsUsing the PubMed, EMBASE, and Cochrane Library databases, we performed a literature search of available randomized controlled trials (RCTs) published as original articles before September 2017.ResultsNine RCTs, involving 1520 patients, were included in the meta-analysis. The pooled relative risks (RRs) for the efficacy of ceftriaxone combination therapy versus respiratory fluoroquinolones monotherapy were 0.96 (95% CI: 0.92-1.01), based on clinically evaluable populations, and 0.93 (95% CI: 0.88-0.99) based on intention-to-treat (ITT) populations. No statistically significant differences were observed in microbiological treatment success (pooled RR=0.99, 95% CI: 0.90-1.09), although drug-related adverse events were significantly lower with ceftriaxone combination therapy than with respiratory fluoroquinolones monotherapy (pooled RR=1.27, 95% CI: 1.04-1.55).ConclusionsCurrent evidence showed that the efficacy of ceftriaxone combination therapy was similar to respiratory fluoroquinolone monotherapy for hospitalized CAP patients, and was associated with lower drug-related adverse events.Copyright © 2018 Elsevier Inc. All rights reserved.

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