Thirteen studies were included (n=4,314 of whom 3,402 could be analysed). The median quality score was 6.67 (range 6 to 8.17).
There were no significant differences observed between treatments, and no significant heterogeneity was observed between the studies for atypical coverage versus no atypical coverage (six studies).
There was no evidence to suggest that antibacterials active against atypical pathogens were superior to other antibacterials when comparing antibacterials such as fluoroquinolones and macrolides (five studies) or cephalosporins compared with β-lactam/β-lactamase inhibitors (two studies).
Five studies reported 24 deaths (mortality 0.7 per cent). There was no difference in mortality rates between patients treated with atypical agents compared with other drugs and no differences between those treated with fluoroquinolones and macrolides .