1. Evidence Behind the 4-Hour Rule for Initiation of Antibiotic Therapy in Community- Acquired Pneumonia 
Kenneth T. Yu, MD, MBA, Peter C. Wyer, MD 
Annals of Emergency Medicine 
Volume 51, Issue 5, Pages e2 (May 2008)
DOI: /j.annemergmed
Copyright © 2008 American College of Emergency Physicians Terms and Conditions

2. Figure 1
Process of selecting included studies (completed August 21, 2006).
Annals of Emergency Medicine  , e2DOI: ( /j.annemergmed )
Copyright © 2008 American College of Emergency Physicians Terms and Conditions

3. Figure 2
4-hour time to antibiotics versus mortality. Forest plot of studies reporting inpatient or 30-day mortality in patients with community-acquired pneumonia receiving antibiotics within 4 hours compared to patients receiving antibiotics later than 4 hours. Odds ratios and 95% confidence intervals (CIs) are provided for each study, with the round dots representing the point estimates and the horizontal lines the CIs. Studies identified as A, B, C and D correspond to uncontrolled retrospective studies, controlled retrospective studies, uncontrolled prospective studies and controlled prospective studies, respectively. The adjusted OR for the study by Silber was calculated by the authors.
*severity-adjusted using Pneumonia Severity Index (PSI).
Annals of Emergency Medicine  , e2DOI: ( /j.annemergmed )
Copyright © 2008 American College of Emergency Physicians Terms and Conditions

4. Figure 3
8-hour time to antibiotics versus mortality. Forest plot of studies reporting inpatient or 30-day mortality in patients with community-acquired pneumonia receiving antibiotics within 8 hours compared to patients receiving antibiotics later than 8 hours. Odds ratios and 95% confidence intervals (CIs) are provided for each study as in Figure 2. Studies are categorized (A, B, C and D) as in Figure 2.
*severity-adjusted using Pneumonia Severity Index (PSI).
Annals of Emergency Medicine  , e2DOI: ( /j.annemergmed )
Copyright © 2008 American College of Emergency Physicians Terms and Conditions