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Comment & Response |

Management of Community-Acquired Pneumonia—Reply

Jonathan S. Lee, MD1; Daniel L. Giesler, MD, PharmD2; Michael J. Fine, MD, MSc3
[+] Author Affiliations
1Division of General Internal Medicine, University of California, San Francisco
2Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
3Center for Health Equity Research and Promotion, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
JAMA. 2016;316(2):222-223. doi:10.1001/jama.2016.5028.
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In Reply Dr Paul and colleagues question our decision to exclude observational studies that did not perform statistical adjustment for illness severity or comorbidity when assessing the association between time to initiate antibiotic therapy and mortality. All studies meeting eligibility for this question were observational in design and had a high likelihood of confounding by indication (ie, patients who were more severely ill would be more likely to have antibiotic therapy initiated rapidly). Therefore, we considered it imperative to focus the review on studies with adjustment for such confounding.

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July 12, 2016
Mical Paul, MD; Dafna Yahav, MD; Leonard Leibovici, MD
1Infectious Diseases Institute, Rambam Health Care Campus, Haifa, Israel
2Unit of Infectious Diseases, Rabin Medical Center, Petah-Tikva, Israel
3Medicine E, Rabin Medical Center, Petah-Tikva, Israel
JAMA. 2016;316(2):220-221. doi:10.1001/jama.2016.5013.
July 12, 2016
Mazen S. Bader, MD, MPH
1Department of Medicine, Juravinski Hospital and Cancer Centre, Hamilton, Ontario, Canada
JAMA. 2016;316(2):221. doi:10.1001/jama.2016.5019.
July 12, 2016
Cornelis H. van Werkhoven, MD, PhD; Jan Jelrik Oosterheert, MD, PhD; Marc J. M. Bonten, MD, PhD
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
JAMA. 2016;316(2):221-222. doi:10.1001/jama.2016.5022.
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