Meta-analyses on the Prevention and Treatment of Respiratory Tract Infections

Infectious Disease Clinics of North America

Volumn 23, Issue 2, 2009, Pages 331-353

  Siempos, Ilias I ^a   Dimopoulos, George ^a,b   Falagas, Matthew E ^a,c,d  

^a ALFA INSTITUTE OF BIOMEDICAL SCIENCES AIBS   (Greece)

^b NATIONAL AND KAPODISTRIAN UNIVERSITY OF ATHENS   (Greece)

^c HENRY DUNANT HOSPITAL   (Greece)

^d TUFTS UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

Acinetobacter baumannii; Health care associated pneumonia; ICU; Pseudomonas aeruginosa; Staphylococcus aureus; Streptococcus pneumoniae; Ventilator associated pneumonia

Indexed keywords

AMOXICILLIN; AMPICILLIN; AZITHROMYCIN; BETA LACTAM ANTIBIOTIC; BROMELAIN; CEFDINIR; CEFOTIAM; CEFPODOXIME; CEFUROXIME; CEPHALOSPORIN; CIPROFLOXACIN PLUS DEXAMETHASONE; CLINDAMYCIN; CORTICOSTEROID; COTRIMOXAZOLE; DOXYCYCLINE; GATIFLOXACIN; HYDROCORTISONE; INFLUENZA VACCINE; LEVOFLOXACIN; MACROLIDE; MOXIFLOXACIN; NEOMYCIN; OFLOXACIN; PENICILLIN G; PIVAMPICILLIN; PNEUMOCOCCUS VACCINE; POLYMYXIN B; QUINOLONE; SINUPRET; UNINDEXED DRUG;

ACUTE OTITIS MEDIA; ACUTE SINUSITIS; ACUTE SUPPURATIVE OTITIS MEDIA; ANTIBIOTIC PROPHYLAXIS; ANTIBIOTIC THERAPY; ANTIMICROBIAL THERAPY; ARTIFICIAL VENTILATION; BODY POSTURE; CHRONIC OBSTRUCTIVE LUNG DISEASE; COMMUNITY ACQUIRED PNEUMONIA; DIET THERAPY; DISEASE COURSE; DISEASE EXACERBATION; ECONOMIC ASPECT; ENDOTRACHEAL INTUBATION; ENTERIC FEEDING; EXTERNAL OTITIS; HOSPITAL INFECTION; HOSPITALIZATION; HUMAN; HYPERCAPNIA; INFLUENZA; INFLUENZA VACCINATION; MORBIDITY; MORTALITY; OTITIS; PATIENT CARE; PHARYNGITIS; PNEUMONIA; PREVALENCE; RECURRENT DISEASE; RESPIRATORY FAILURE; RESPIRATORY TRACT INFECTION; REVIEW; SINUSITIS; STREPTOCOCCAL PHARYNGITIS; STRESS ULCER; SURGICAL DRAINAGE; TONSILLITIS; TRACHEOSTOMY; TREATMENT DURATION; TREATMENT FAILURE; TUBE FEEDING; VENTILATOR ASSOCIATED PNEUMONIA; WASTE MANAGEMENT;

ACINETOBACTER INFECTIONS; CROSS INFECTION; HUMANS; META-ANALYSIS AS TOPIC; PNEUMONIA, PNEUMOCOCCAL; PNEUMONIA, VENTILATOR-ASSOCIATED; PSEUDOMONAS INFECTIONS; RESPIRATORY TRACT INFECTIONS; STAPHYLOCOCCAL INFECTIONS; UNITED STATES;

EID: 64849109386     PISSN: 08915520     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.idc.2009.01.006     Document Type: Review

References (118)

1. Connors Jr. A.F., Dawson N.V., Thomas C., et al. Outcomes following acute exacerbation of severe chronic obstructive lung disease. The SUPPORT investigators (Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments). Am J Respir Crit Care Med 154 4 Pt 1 (1996) 959-967
2. National Centre for Health Statistics. Health, United States, 2006, with chartbook on trends in the health of Americans. Available at:. http://www.cdc.gov/nchs/data/hus/hus07.pdf#highlights Assessed November 28, 2008
3. Siempos II, Athanassa Z., and Falagas M.E. Frequency and predictors of ventilator-associated pneumonia recurrence: a meta-analysis. Shock 30 5 (2008) 487-495
4. Chastre J., and Fagon J.Y. Ventilator-associated pneumonia. Am J Respir Crit Care Med 165 7 (2002) 867-903
5. Rosenfeld R.M., Singer M., Wasserman J.M., et al. Systematic review of topical antimicrobial therapy for acute otitis externa. Otolaryngol Head Neck Surg 134 4 Suppl (2006) S24-S48
6. Rahman A., Rizwan S., Waycaster C., et al. Pooled analysis of two clinical trials comparing the clinical outcomes of topical ciprofloxacin/dexamethasone otic suspension and polymyxin B/neomycin/hydrocortisone otic suspension for the treatment of acute otitis externa in adults and children. Clin Ther 29 9 (2007) 1950-1956
7. Abes G., Espallardo N., Tong M., et al. A systematic review of the effectiveness of ofloxaxin otic solution for the treatment of suppurative otitis media. ORL J Otorhinolaryngol Relat Spec 65 2 (2003) 106-116
8. Ioannidis J.P., Contopoulos-Ioannidis D.G., Chew P., et al. Meta-analysis of randomized controlled trials on the comparative efficacy and safety of azithromycin against other antibiotics for upper respiratory tract infections. J Antimicrob Chemother 48 5 (2001) 677-689
9. Falagas M.E., Giannopoulou K.P., Vardakas K.Z., et al. Comparison of antibiotics with placebo for treatment of acute sinusitis: a meta-analysis of randomised controlled trials. Lancet Infect Dis 8 9 (2008) 543-552
10. Young J., De Sutter A., Merenstein D., et al. Antibiotics for adults with clinically diagnosed acute rhinosinusitis: a meta-analysis of individual patient data. Lancet 371 9616 (2008) 908-914
11. Ahovuo-Saloranta A., Borisenko O.V., Kovanen N., et al. Antibiotics for acute maxillary sinusitis. Cochrane Database Syst Rev 2 (2008) CD000243
12. Rosenfeld RM, Singer M, Jones S. Systematic review of antimicrobial therapy in patients with acute rhinosinusitis. Otolaryngol Head Neck Surg;137(3 Suppl):S32-45.
13. de Bock G.H., Dekker F.W., Stolk J., et al. Antimicrobial treatment in acute maxillary sinusitis: a meta-analysis. J Clin Epidemiol 50 8 (1997) 881-890
14. Karageorgopoulos D.E., Giannopoulou K.P., Grammatikos A.P., et al. Fluoroquinolones compared with beta-lactam antibiotics for the treatment of acute bacterial sinusitis: a meta-analysis of randomized controlled trials. CMAJ 178 7 (2008) 845-854
15. de Ferranti S.D., Ioannidis J.P., Lau J., et al. Are amoxycillin and folate inhibitors as effective as other antibiotics for acute sinusitis? A meta-analysis. BMJ 317 7159 (1998) 632-637
16. Zalmanovici A., and Yaphe J. Steroids for acute sinusitis. Cochrane Database Syst Rev 2 (2007) CD005149
17. Guo R., Canter P.H., and Ernst E. Herbal medicines for the treatment of rhinosinusitis: a systematic review. Otolaryngol Head Neck Surg 135 4 (2006) 496-506
18. Casey J.R., and Pichichero M.E. Higher dosages of azithromycin are more effective in treatment of group A streptococcal tonsillopharyngitis. Clin Infect Dis 40 12 (2005) 1748-1755
19. Casey J.R., and Pichichero M.E. Meta-analysis of cephalosporins versus penicillin for treatment of group A streptococcal tonsillopharyngitis in adults. Clin Infect Dis 38 11 (2004) 1526-1534
20. Falagas M.E., Vouloumanou E.K., Matthaiou D.K., et al. Effectiveness and safety of short-course vs long-course antibiotic therapy for group a beta hemolytic streptococcal tonsillopharyngitis: a meta-analysis of randomized trials. Mayo Clin Proc 83 8 (2008) 880-889
21. Pichichero M.E., and Casey J.R. Bacterial eradication rates with shortened courses of 2nd- and 3rd-generation cephalosporins versus 10 days of penicillin for treatment of group A streptococcal tonsillopharyngitis in adults. Diagn Microbiol Infect Dis 59 2 (2007) 127-130
22. Granger R., Walters J., Poole P.J., et al. Injectable vaccines for preventing pneumococcal infection in patients with chronic obstructive pulmonary disease. Cochrane Database Syst Rev 4 (2006) CD001390
23. Poole P.J., Chacko E., Wood-Baker R.W., et al. Influenza vaccine for patients with chronic obstructive pulmonary disease. Cochrane Database Syst Rev 1 (2006) CD002733
24. Black P., Staykova T., Chacko E., et al. Prophylactic antibiotic therapy for chronic bronchitis. Cochrane Database Syst Rev 1 (2003) CD004105
25. Puhan M.A., Vollenweider D., Latshang T., et al. Exacerbations of chronic obstructive pulmonary disease: when are antibiotics indicated? A systematic review. Respir Res 8 (2007) 30
26. Ram F.S., Rodriguez-Roisin R., Granados-Navarrete A., et al. Antibiotics for exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2 (2006) CD004403
27. Saint S., Bent S., Vittinghoff E., et al. Antibiotics in chronic obstructive pulmonary disease exacerbations. A meta-analysis. JAMA 273 12 (1995) 957-960
28. Puhan M.A., Vollenweider D., Steurer J., et al. Where is the supporting evidence for treating mild to moderate chronic obstructive pulmonary disease exacerbations with antibiotics? A systematic review. BMC Med 6 (2008) 28
29. Korbila I.P., Manta K.G., Siempos I.I., et al. Penicillins vs trimethoprim based regimens for acute bacterial exacerbations of chronic bronchitis: a meta-analysis of randomized controlled trials. Can Fam Physician 55 (2009) 60-67
30. Dimopoulos G., Siempos II, Korbila I.P., et al. Comparison of first-line with second-line antibiotics for acute exacerbations of chronic bronchitis: a metaanalysis of randomized controlled trials. Chest 132 2 (2007) 447-455
31. Siempos II, Dimopoulos G., Korbila I.P., et al. Macrolides, quinolones and amoxicillin/clavulanate for chronic bronchitis: a meta-analysis. Eur Respir J 29 6 (2007) 1127-1137
32. Panpanich R., Lerttrakarnnon P., and Laopaiboon M. Azithromycin for acute lower respiratory tract infections. Cochrane Database Syst Rev 1 (2008) CD001954
33. Falagas M.E., Avgeri S.G., Matthaiou D.K., et al. Short- versus long-duration antimicrobial treatment for exacerbations of chronic bronchitis: a meta-analysis. J Antimicrob Chemother 62 3 (2008) 442-450
34. El Moussaoui R., Roede B.M., Speelman P., et al. Short-course antibiotic treatment in acute exacerbations of chronic bronchitis and COPD: a meta-analysis of double-blind studies. Thorax 63 5 (2008) 415-422
35. McCrory D.C., and Brown C.D. Anti-cholinergic bronchodilators versus beta2-sympathomimetic agents for acute exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev 4 (2002) CD003900
36. Barr R.G., Rowe B.H., and Camargo Jr. C.A. Methylxanthines for exacerbations of chronic obstructive pulmonary disease: meta-analysis of randomised trials. BMJ 327 7416 (2003) 643
37. Quon B.S., Gan W.Q., and Sin D.D. Contemporary management of acute exacerbations of COPD: a systematic review and metaanalysis. Chest 133 3 (2008) 756-766
38. Wood-Baker R.R., Gibson P.G., Hannay M., et al. Systemic corticosteroids for acute exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev 1 (2005) CD001288
39. Poole P.J., and Black P.N. Oral mucolytic drugs for exacerbations of chronic obstructive pulmonary disease: systematic review. BMJ 322 7297 (2001) 1271-1274
40. Ram F.S., Picot J., Lightowler J., et al. Non-invasive positive pressure ventilation for treatment of respiratory failure due to exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev 3 (2004) CD004104
41. Keenan S.P., Sinuff T., Cook D.J., et al. Which patients with acute exacerbation of chronic obstructive pulmonary disease benefit from noninvasive positive-pressure ventilation? A systematic review of the literature. Ann Intern Med 138 11 (2003) 861-870
42. Lightowler J.V., Wedzicha J.A., Elliott M.W., et al. Non-invasive positive pressure ventilation to treat respiratory failure resulting from exacerbations of chronic obstructive pulmonary disease: Cochrane systematic review and meta-analysis. BMJ 326 7382 (2003) 185
43. Keenan S.P., Gregor J., Sibbald W.J., et al. Noninvasive positive pressure ventilation in the setting of severe, acute exacerbations of chronic obstructive pulmonary disease: more effective and less expensive. Crit Care Med 28 6 (2000) 2094-2102
44. Keenan S.P., Kernerman P.D., Cook D.J., et al. Effect of noninvasive positive pressure ventilation on mortality in patients admitted with acute respiratory failure: a meta-analysis. Crit Care Med 25 10 (1997) 1685-1692
45. Mills G.D., Oehley M.R., and Arrol B. Effectiveness of beta lactam antibiotics compared with antibiotics active against atypical pathogens in non-severe community acquired pneumonia: meta-analysis. BMJ 330 7489 (2005) 456
46. British Thoracic Society Standards of Care Committee. BTS guidelines for the management of community acquired pneumonia in adults. Thorax 56 Suppl 4 (2001) IV1-64
47. Mandell L.A., Wunderink R.G., Anzueto A., et al. Infectious Diseases Society of America; American Thoracic Society. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis 44 Suppl 2 (2007) S27-S72
48. Robenshtok E., Shefet D., Gafter-Gvili A., et al. Empiric antibiotic coverage of atypical pathogens for community acquired pneumonia in hospitalized adults. Cochrane Database Syst Rev 1 (2008) CD004418
49. Shefet D., Robenshtok E., Paul M., et al. Empirical atypical coverage for inpatients with community-acquired pneumonia: systematic review of randomized controlled trials. Arch Intern Med 165 17 (2005) 1992-2000
50. Maimon N., Nopmaneejumruslers C., and Marras T.K. Antibacterial class is not obviously important in outpatient pneumonia: a meta-analysis. Eur Respir J 31 5 (2008) 1068-1076
51. Vardakas K.Z., Siempos II, Grammatikos A., et al. Respiratory fluoroquinolones for the treatment of community-acquired pneumonia: a meta-analysis of randomized controlled trials. CMAJ 179 12 (2008) 1269-1277
52. Mittmann N., Jivarj F., Wong A., et al. Oral fluoroquinolones in the treatment of pneumonia, bronchitis and sinusitis. Can J Infect Dis 13 5 (2002) 293-300
53. Salkind A.R., Cuddy P.G., and Foxworth J.W. Fluoroquinolone treatment of community-acquired pneumonia: a meta-analysis. Ann Pharmacother 36 12 (2002) 1938-1943
54. Fogarty C., Torres A., Choudhri S., et al. Efficacy of moxifloxacin for treatment of penicillin-, macrolide- and multidrug-resistant Streptococcus pneumoniae in community-acquired pneumonia. Int J Clin Pract 59 11 (2005) 1253-1259
55. Hoeffken G., Talan D., Larsen L.S., et al. Efficacy and safety of sequential moxifloxacin for treatment of community-acquired pneumonia associated with atypical pathogens. Eur J Clin Microbiol Infect Dis 23 10 (2004) 772-775
56. Tennenberg A.M., Davis N.B., Wu S.C., et al. Pneumonia due to Pseudomonas aeruginosa: the levofloxacin clinical trials experience. Curr Med Res Opin 22 5 (2006) 843-850
57. Bru J.P., Leophonte P., and Veyssier P. [Levofloxacine for the treatment of pneumococcal pneumonia: results of a meta-analysis]. Rev Pneumol Clin 59 6 (2003) 348-356 [in French]
58. Contopoulos-Ioannidis D.G., Ioannidis J.P., Chew P., et al. Meta-analysis of randomized controlled trials on the comparative efficacy and safety of azithromycin against other antibiotics for lower respiratory tract infections. J Antimicrob Chemother 48 5 (2001) 691-703
59. Falagas M.E., Siempos II, Bliziotis I.A., et al. Impact of initial discordant treatment with β-lactam antibiotics on clinical outcomes in adults with pneumococcal pneumonia: a systematic review. Mayo Clin Proc 81 12 (2006) 1567-1574
60. Dimopoulos G., Matthaiou D.K., Karageorgopoulos D.E., et al. Short- versus long-course antibacterial therapy for community-acquired pneumonia: a meta-analysis. Drugs 68 13 (2008) 1841-1854
61. Li J.Z., Winston L.G., Moore D.H., et al. Efficacy of short-course antibiotic regimens for community-acquired pneumonia: a meta-analysis. Am J Med 120 9 (2007) 783-790
62. Athanassa Z., Makris G., Dimopoulos G., et al. Early switch to oral treatment in patients with moderate to severe community-acquired pneumonia: a meta-analysis. Drugs 68 17 (2008) 2469-2481
63. Rhew D.C., Tu G.S., Ofman J., et al. Early switch and early discharge strategies in patients with community-acquired pneumonia: a meta-analysis. Arch Intern Med 161 5 (2001) 722-727
64. Siempos II, Vardakas K.Z., Kopterides P., et al. Adjunctive therapies for community-acquired pneumonia: a systematic review. J Antimicrob Chemother 62 4 (2008) 661-668
65. Salluh J.I., Póvoa P., Soares M., et al. The role of corticosteroids in severe community-acquired pneumonia: a systematic review. Crit Care 12 3 (2008) R76
66. Griffiths J., Barber V.S., Morgan L., et al. Systematic review and meta-analysis of studies of the timing of tracheostomy in adult patients undergoing artificial ventilation. BMJ 330 7502 (2005) 1243
67. Goldhill D.R., Imhoff M., McLean B., et al. Rotational bed therapy to prevent and treat respiratory complications: a review and meta-analysis. Am J Crit Care 16 1 (2007) 50-61
68. Delaney A., Gray H., Laupland K.B., et al. Kinetic bed therapy to prevent nosocomial pneumonia in mechanically ventilated patients: a systematic review and meta-analysis. Crit Care 10 3 (2006) R70
69. Sud S., Sud M., Friedrich J.O., et al. Effect of mechanical ventilation in the prone position on clinical outcomes in patients with acute hypoxemic respiratory failure: a systematic review and meta-analysis. CMAJ 178 9 (2008) 1153-1161
70. Abroug F., Ouanes-Besbes L., Elatrous S., et al. The effect of prone positioning in acute respiratory distress syndrome or acute lung injury: a meta-analysis. Areas of uncertainty and recommendations for research. Intensive Care Med 34 6 (2008) 1002-1011
71. Tiruvoipati R., Bangash M., Manktelow B., et al. Efficacy of prone ventilation in adult patients with acute respiratory failure: a meta-analysis. J Crit Care 23 1 (2008) 101-110
72. Alsaghir A.H., and Martin C.M. Effect of prone positioning in patients with acute respiratory distress syndrome: a meta-analysis. Crit Care Med 36 2 (2008) 603-609
73. Siempos II, Vardakas K.Z., and Falagas M.E. Closed tracheal suction systems for prevention of ventilator-associated pneumonia. Br J Anaesth 100 3 (2008) 299-306
74. Subirana M., Solà I., and Benito S. Closed tracheal suction systems versus open tracheal suction systems for mechanically ventilated adult patients. Cochrane Database Syst Rev 4 (2007) CD004581
75. Niël-Weise B.S., Snoeren R.L., and van den Broek P.J. Policies for endotracheal suctioning of patients receiving mechanical ventilation: a systematic review of randomized controlled trials. Infect Control Hosp Epidemiol 28 5 (2007) 531-536
76. Peter J.V., Chacko B., and Moran J.L. Comparison of closed endotracheal suction versus open endotracheal suction in the development of ventilator-associated pneumonia in intensive care patients: an evaluation using meta-analytic techniques. Indian J Med Sci 61 4 (2007) 201-211
77. Jongerden I.P., Rovers M.M., Grypdonck M.H., et al. Open and closed endotracheal suction systems in mechanically ventilated intensive care patients: a meta-analysis. Crit Care Med 35 1 (2007) 260-270
78. Vonberg R.P., Eckmanns T., Welte T., et al. Impact of the suctioning system (open vs. closed) on the incidence of ventilation-associated pneumonia: meta-analysis of randomized controlled trials. Intensive Care Med 32 9 (2006) 1329-1335
79. Siempos II, Vardakas K.Z., Kopterides P., et al. Impact of passive humidification on clinical outcomes of mechanically ventilated patients: a meta-analysis of randomized controlled trials. Crit Care Med 35 12 (2007) 2843-2851
80. Niël-Weise B.S., Wille J.C., and van den Broek P.J. Humidification policies for mechanically ventilated intensive care patients and prevention of ventilator-associated pneumonia: a systematic review of randomized controlled trials. J Hosp Infect 65 4 (2007) 285-291
81. Kola A., Eckmanns T., and Gastmeier P. Efficacy of heat and moisture exchangers in preventing ventilator-associated pneumonia: meta-analysis of randomized controlled trials. Intensive Care Med 31 1 (2005) 5-11
82. Hess D.R., Kallstrom T.J., Mottram C.D., et al., American Association for Respiratory Care. Care of the ventilator circuit and its relation to ventilator-associated pneumonia. Respir Care 48 9 (2003) 869-879
83. American Thoracic Society. Infectious Diseases Society of America. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med. 171 4 (2005) 388-416
84. Tablan O.C., Anderson L.J., Besser R., et al., Healthcare Infection Control Practices Advisory Committee. Guidelines for preventing health-care-associated pneumonia, 2003: recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee. MMWR Recomm Rep 53 RR-3 (2004) 1-36
85. Dezfulian C., Shojania K., Collard H.R., et al. Subglottic secretion drainage for preventing ventilator-associated pneumonia: a meta-analysis. Am J Med 118 1 (2005) 11-18
86. Hess D.R. Noninvasive positive-pressure ventilation and ventilator-associated pneumonia. Respir Care 50 7 (2005) 924-929
87. Burns K.E., Adhikari N.K., and Meade M.O. A meta-analysis of noninvasive weaning to facilitate liberation from mechanical ventilation. Can J Anaesth 53 3 (2006) 305-315
88. Burns K.E., Adhikari N.K., and Meade M.O. Noninvasive positive pressure ventilation as a weaning strategy for intubated adults with respiratory failure. Cochrane Database Syst Rev 4 (2003) CD004127
89. Ho K.M., Dobb G.J., and Webb S.A. A comparison of early gastric and post-pyloric feeding in critically ill patients: a meta-analysis. Intensive Care Med 32 5 (2006) 639-649
90. Marik P.E., and Zaloga G.P. Gastric versus post-pyloric feeding: a systematic review. Crit Care 7 3 (2003) R46-R51
91. Messori A., Trippoli S., Vaiani M., et al. Bleeding and pneumonia in intensive care patients given ranitidine and sucralfate for prevention of stress ulcer: meta-analysis of randomised controlled trials. BMJ 321 7269 (2000) 1103-1106
92. Cook D.J., Reeve B.K., Guyatt G.H., et al. Stress ulcer prophylaxis in critically ill patients. Resolving discordant meta-analyses. JAMA 275 4 (1996) 308-314
93. Cook D.J., Reeve B.K., and Scholes L.C. Histamine-2-receptor antagonists and antacids in the critically ill population: stress ulceration versus nosocomial pneumonia. Infect Control Hosp Epidemiol 15 7 (1994) 437-442
94. Cook D.J., Laine L.A., Guyatt G.H., et al. Nosocomial pneumonia and the role of gastric pH. A meta-analysis. Chest 100 1 (1991) 7-13
95. Tryba M. Sucralfate versus antacids or H2-antagonists for stress ulcer prophylaxis: a meta-analysis on efficacy and pneumonia rate. Crit Care Med 19 7 (1991) 942-949
96. Tryba M. Prophylaxis of stress ulcer bleeding. A meta-analysis. J Clin Gastroenterol. 13 Suppl 2 (1991) S44-S55
97. Chlebicki M.P., and Safdar N. Topical chlorhexidine for prevention of ventilator-associated pneumonia: a meta-analysis. Crit Care Med 35 2 (2007) 595-602
98. Chan E.Y., Ruest A., Meade M.O., et al. Oral decontamination for prevention of pneumonia in mechanically ventilated adults: systematic review and meta-analysis. BMJ 334 7599 (2007) 889
99. Siempos II, and Falagas M.E. Oral decontamination with chlorhexidine reduces the incidence of nosocomial pneumonia. Crit Care 11 1 (2007) 402
100. Pineda L.A., Saliba R.G., and El Solh A.A. Effect of oral decontamination with chlorhexidine on the incidence of nosocomial pneumonia: a meta-analysis. Crit Care 10 1 (2006) R35
101. Liberati A., D'Amico R., Pifferi, et al. Antibiotic prophylaxis to reduce respiratory tract infections and mortality in adults receiving intensive care. Cochrane Database Syst Rev. 1 (2004) CD000022
102. Nathens A.B., and Marshall J.C. Selective decontamination of the digestive tract in surgical patients: a systematic review of the evidence. Arch Surg 134 2 (1999) 170-176
103. Kollef M.H. The role of selective digestive tract decontamination on mortality and respiratory tract infections. A meta-analysis. Chest 105 4 (1994) 1101-1108
104. Falagas M.E., Siempos II, Bliziotis I.A., et al. Administration of antibiotics via the respiratory tract for the prevention of ICU-acquired pneumonia: a meta-analysis of comparative trials. Crit Care 10 4 (2006) R123
105. Falagas M.E., and Siempos II. Prevention of ventilator-associated pneumonia: possible role of antimicrobials administered via the respiratory tract. Eur Respir J 31 5 (2008) 1138-1139
106. Watkinson P.J., Barber V.S., Dark P., et al. The use of pre- pro- and synbiotics in adult intensive care unit patients: systematic review. Clin Nutr 26 2 (2007) 182-192
107. Montejo J.C., Zarazaga A., López-Martínez J., et al. Spanish Society of Intensive Care Medicine and Coronary Units. Immunonutrition in the intensive care unit. A systematic review and consensus statement. Clin Nutr 22 3 (2003) 221-233
108. Aarts M.A., Hancock J.N., Heyland D., et al. Empiric antibiotic therapy for suspected ventilator-associated pneumonia: a systematic review and meta-analysis of randomized trials. Crit Care Med 36 1 (2008) 108-117
109. Siempos II, Vardakas K.Z., Manta K.G., et al. Carbapenems for the treatment of immunocompetent adult patients with nosocomial pneumonia. Eur Respir J 29 3 (2007) 548-560
110. Shorr A.F., Susla G.B., and Kollef M.H. Quinolones for treatment of nosocomial pneumonia: a meta-analysis. Clin Infect Dis 40 Suppl 2 (2005) S115-S122
111. Falagas M.E., Siempos II, and Vardakas K.Z. Linezolid versus glycopeptide or beta-lactam for treatment of gram-positive bacterial infections: meta-analysis of randomised controlled trials. Lancet Infect Dis 8 1 (2008) 53-66
112. Ioannidou E., Siempos II, and Falagas M.E. Administration of antimicrobials via the respiratory tract for the treatment of patients with nosocomial pneumonia: a meta-analysis. J Antimicrob Chemother 60 6 (2007) 1216-1226
113. Falagas M.E., Agrafiotis M., Athanassa Z., et al. Administration of antibiotics via the respiratory tract as monotherapy for pneumonia. Expert Rev Anti Infect Ther 6 4 (2008) 447-452
114. Cook D.J., Mulrow C.D., and Haynes R.B. Systematic reviews: synthesis of best evidence for clinical decisions. Ann Intern Med 126 5 (1997) 376-380
115. Tobin M.J., and Jubran A. Meta-analysis under the spotlight: focused on a meta-analysis of ventilator weaning. Crit Care Med 36 1 (2008) 1-7
116. Siempos II, Michalopoulos A, Falagas ME. Treatment of acute bacterial exacerbations of chronic bronchitis. Expert Opin Pharmacother [in press].
117. Winchester C.C., Macfarlane T., Thomas M., et al. Antibiotic prescribing and outcomes of lower respiratory tract infection in UK primary care. Chest (2008) in press
118. Grammatikos A.P., Siempos I.I., Michalopoulos A., et al. Optimal duration of antimicrobial treatment of ventilator-acquired pneumonia. Expert Rev Anti Infect Ther 6 (2008) 861-866