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Clinical failure with and without empiric atypical bacteria coverage in hospitalized adults with community-acquired pneumonia: a systematic review and meta-analysis

Overview of attention for article published in BMC Infectious Diseases, June 2017
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  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (90th percentile)

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37 tweeters
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2 Facebook pages

Citations

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2 Dimensions

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38 Mendeley
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Title
Clinical failure with and without empiric atypical bacteria coverage in hospitalized adults with community-acquired pneumonia: a systematic review and meta-analysis
Published in
BMC Infectious Diseases, June 2017
DOI 10.1186/s12879-017-2495-5
Pubmed ID
Authors

Khalid Eljaaly, Samah Alshehri, Ahmed Aljabri, Ivo Abraham, Mayar Al Mohajer, Andre C. Kalil, David E. Nix

Abstract

Both typical and atypical bacteria can cause community-acquired pneumonia (CAP); however, the need for empiric atypical coverage remains controversial. Our objective was to evaluate the impact of antibiotic regimens with atypical coverage (a fluoroquinolone or combination of a macrolide/doxycycline with a β-lactam) to a regimen without atypical antibiotic coverage (β-lactam monotherapy) on rates of clinical failure (primary endpoint), mortality, bacteriologic failure, and adverse events, (secondary endpoints). We searched the PubMed, EMBASE and Cochrane Library databases for relevant RCTs of hospitalized CAP adults. We estimated risk ratios (RRs) with 95% confidence intervals (CIs) using a fixed-effect model, but used a random-effects model if significant heterogeneity (I (2) ) was observed. Five RCTs with a total of 2011 patients were retained. A statistically significant lower clinical failure rate was observed with empiric atypical coverage (RR, 0.851 [95% CI, 0.732-0.99; P = 0.037]; I (2)  = 0%). The secondary outcomes did not differ between the two study groups: mortality (RR = 0.549 [95% CI, 0.259-1.165, P = 0.118], I (2)  = 61.434%) bacteriologic failure (RR = 0.816 [95% CI, 0.523-1.272, P = 0.369], I (2)  = 0%), diarrhea (RR = 0.746 [95% CI, 0.311-1.790, P = 0.512], I (2)  = 65.048%), and adverse events requiring antibiotic discontinuation (RR = 0.83 [95% CI, 0.542-1.270, P = 0.39], I (2)  = 0%). Empiric atypical coverage was associated with a significant reduction in clinical failure in hospitalized adults with CAP. Reduction in mortality, bacterial failure, diarrhea, and discontinuation due to adverse effects were not significantly different between groups, but all estimates favored atypical coverage. Our findings provide support for the current guidelines recommendations to include empiric atypical coverage.

Twitter Demographics

The data shown below were collected from the profiles of 37 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 38 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 38 100%

Demographic breakdown

Readers by professional status Count As %
Unspecified 7 18%
Researcher 7 18%
Student > Master 4 11%
Student > Bachelor 4 11%
Student > Ph. D. Student 4 11%
Other 12 32%
Readers by discipline Count As %
Medicine and Dentistry 16 42%
Unspecified 10 26%
Pharmacology, Toxicology and Pharmaceutical Science 5 13%
Agricultural and Biological Sciences 2 5%
Immunology and Microbiology 2 5%
Other 3 8%

Attention Score in Context

This research output has an Altmetric Attention Score of 23. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 28 September 2019.
All research outputs
#713,532
of 13,600,232 outputs
Outputs from BMC Infectious Diseases
#122
of 5,068 outputs
Outputs of similar age
#24,178
of 267,177 outputs
Outputs of similar age from BMC Infectious Diseases
#1
of 1 outputs
Altmetric has tracked 13,600,232 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 94th percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 5,068 research outputs from this source. They receive a mean Attention Score of 4.8. This one has done particularly well, scoring higher than 97% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 267,177 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 90% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them