Randomised controlled trials (RCTs) that compared the same antibacterial regimens in the same doses, but with one arm having a short course of treatment (seven days maximum) and one arm with a long course of treatment (at least two days longer than the short course) were eligible for inclusion. Patients of all ages (except neonates) were included provided that they had a diagnosis of community acquired pneumonia of any severity, based on at least two types of criteria (clinical, radiological and microbiological). Eligible trials were required to report one of the outcomes of interest.
The primary effectiveness outcome of interest was clinical success, defined as complete resolution or improvement of symptoms and signs of community-acquired pneumonia, assessed at the end of therapy evaluation visit. The primary safety outcome was the total number of adverse events that occurred by the end of the follow-up period. The other outcomes of interest were clinical success at the late follow-up evaluation visit, microbiological success, mortality, and relapse and withdrawals due to adverse events (definitions provided for all outcomes).
The included trials were of adults only or children only. The included children were aged two to 59 months old, with non-severe community-acquired pneumonia and resided in developing countries. The included adults were treated as in-patients or out-patients and none required admission to an intensive care unit; however, the severity of disease was unclear in several trials. The therapies used were gemifloxacin (five versus seven days); amoxicillin (three versus eight days; three versus five days); telithromycin (five versus seven days); ceftriaxone (five versus 10 days); and cefuroxime axetil (seven versus 10 days). The timing for end of therapy evaluation ranged from six to 21 days and from 12 to 45 days for late follow-up.
The authors did not state how many reviewers were involved in study selection.