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Comment & Response
July 12, 2016

Management of Community-Acquired Pneumonia

Author Affiliations
  • 1Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
  • 2Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, Utrecht, the Netherlands
  • 3Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, the Netherlands

Copyright 2016 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA. 2016;316(2):221-222. doi:10.1001/jama.2016.5022

To the Editor Dr Lee and colleagues1 systematically reviewed the literature on empirical antibiotic treatment for patients with community-acquired pneumonia requiring admission to the hospital and concluded that β-lactam plus macrolide combination therapy or fluoroquinolone monotherapy is superior to β-lactam monotherapy. The authors mainly based their conclusion on observational studies, which are prone to residual confounding and usually overestimate treatment effects.2 For the comparison of β-lactam monotherapy with β-lactam plus macrolide combination therapy, the 2 high-quality trials provide evidence for the opposite conclusion.