Study conclusions should reflect results
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* Andrew M. Morris

In their recent meta-analysis of the use of respiratory fluoroquinolones to treat community-acquired pneumonia, Vardakas and colleagues identified all-cause mortality in the intention-to-treat population as their primary outcome measure, but their main conclusion was that fluoroquinolone antibiotics were associated with higher treatment success than comparator antibiotics for severe forms of community-acquired pneumonia (treatment success was a secondary outcome).1 The correct conclusion from their data should be that fluoroquinolones are no better than comparator antibiotics in the treatment of community-acquired pneumonia. A secondary conclusion should be that, in blinded and high-quality studies, there is no difference in mortality rate or treatment success for patients who receive fluoroquinolones versus comparator antibiotics. Moreover, it is unclear why the authors chose to include low-quality trials in their meta-analysis and to base their conclusions on such low-quality studies: this runs counter to common sense.

## Footnotes

*   **Competing interests:** None declared.

## REFERENCE

1.  1. Vardakas KZ, Siempos II, Grammatikos A, et al. Respiratory fluoroquinolones for the treatment of community-acquired pneumonia: a meta-analysis of randomized controlled trials. CMAJ 2008;179:1269-77.
    
    [Abstract/FREE Full Text](http://www.cmaj.ca/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiY21haiI7czo1OiJyZXNpZCI7czoxMToiMTc5LzEyLzEyNjkiO3M6NDoiYXRvbSI7czoyMjoiL2NtYWovMTgwLzcvNzM4LjEuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9)