We recently read the systematic review entitled “Legionella pneumonia in hospitalized adults with respiratory failure: Quinolones or macrolides?” by Ruiz-Spinelli A, and Rello J published in the European Journal of Internal Medicine (2024;120:62–68) and are concerned that there are inconsistencies in the manuscript [1]. In this review the authors compare the impact of quinolone monotherapy to macrolide monotherapy on outcomes for patients with Legionnaires disease. They include ten observation studies in the review, of which two are conducted in cohorts with 100 % of patients admitted to the intensive care unit (ICU) and one with 50 % or more patients admitted to ICU [2-4].
