Ambulatory short-course high-dose oral amoxicillin for treatment of severe pneumonia in children: a randomised equivalency trial

Hazir, Tabish; Fox, LeAnne M.; Nisar, Yasir Bin; Fox, Matthew P.; Ashraf, Yusra Pervaiz; Macleod, W. Bentley; Ramzan, Afroze; Maqbool, Sajid; Masood, Tahir; Hussain, Waqar; Murtaza, A.; Khawar, Nadeem; Tariq, Parveen; Asghar, Rai Muhammad; Simon, Jonathon L; Thea, Donald M.; Qazi, Shamim

doi:10.1016/s0140-6736(08)60071-9

Cited by 161 publications

(163 citation statements)

References 26 publications

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“…This result is much higher than similar study conducted in Pakistan 9 where treatment failure on third day was 5.8%. Study in Pakistan 9 showed that subject with history of previous antibiotics usage could increase treatment failure rate due to the possibilities of pathogen which were resistant or stronger.…”

contrasting

confidence: 61%

“…The studies performed in Pakistan and other countries had similar results which stated that lower chest indrawing is the indicator of treatment failure. 9,12 Inflammation of the lung parenchyma in children with pneumonia causes dysfunction in blood oxygen exchange then induces hypoxemia. Peripheral chemoreceptor located in the carotid body is very sensitive to changes in blood oxygen levels.…”

Section: ≥6 Days 30mentioning

confidence: 99%

“…18 Other study showed that children with severe pneumonia treated with high dose amoxicillin is 80-90 mg/kg per oral every 12 hours had similar failure rate with intravenous ampicillin. 9 This is quite interesting considering that 5 subjects in this study had history of amoxicillin oral treatment for three days, however, the dose given to the patients is unknown.…”

mentioning

confidence: 94%

“…Previous study stated that exclusive breastfeeding could decrease the risk of treatment failure on the sixth day in children aged less than 24 months. 9,16,17 This phenomenon happened because the exclusive breastfeeding itself could increase selfimmunity as natural antimicrobial. 18 Children with exclusive breastfeeding as many as 46 (63.8%) of 72 subjects were hospitalized less than 6 days.…”

mentioning

confidence: 99%

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Treatment Failure of Ampicillin to Children with Pneumonia at Dr. Hasan Sadikin General Hospital Bandung from 2014–2015

Suharno¹,

Husen²,

Sudarwati³

2017

amj

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Background: Pneumonia is one of the causes of death in infants in developing countries especially Indonesia. Appropriate treatment is needed to decrease mortality rate in children due to pneumonia. Ampicillin is one of first choices empirical antibiotic to children with severe pneumonia. The study was aimed to determine the failure rate of ampicillin in children with severe pneumonia. Methods: This study was a descriptive study which used medical records as source of data. Subjects were children aged 2-59 months with World Health Organization (WHO) defined with severe pneumonia and treated with intravenous ampicillin during January 2014 to July 2015 at Dr. Hasan Sadikin General Hospital Bandung. Samples were obtained using total sampling method while variables were analyzed using statistics software. Results: This study acquired 107 patients who met the inclusion criteria with 23.36% of them aged 2-11 months and 62.21% aged 12-23 months. Majority of subjects were male amounted as 63.55% while female occupied 36.45%. Treatment failure on the third day was 45.8% while 16.7% on the sixth day of therapy with majority failure due to existence of lower chest indrawing. Conclusions: Treatment failure on the third and sixth day of therapy still high that is characterized by the existence of lower chest indrawing as its main factor. [AMJ.2017;4(1):100-6]

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contrasting

confidence: 61%

Section: ≥6 Days 30mentioning

confidence: 99%

mentioning

confidence: 94%

mentioning

confidence: 99%

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Treatment Failure of Ampicillin to Children with Pneumonia at Dr. Hasan Sadikin General Hospital Bandung from 2014–2015

Suharno¹,

Husen²,

Sudarwati³

2017

amj

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“…Zadnje raziskave so pokazale, da je zdravljenje s peroralno apliciranim amoksicilinom enako u~inkovito. V klini~ni raziskavi NO-SHOTS so primerjali zdravljenje s parenteralnim ampicilinom in peroralnim amoksicilinom (19). Vanjo je bilo vklju~enih 2037 otrok s plju~nico, starih med 3 in 59 mesecev.…”

Section: Ampicilin Intravensko/amoksicilin Peroralnounclassified

Pharmacokinetics of penicillin antibiotics: intravenous-to-oral switch therapy

Marušič¹,

Locatelli²,

Mrhar³

2010

Slovenian Journal of Public Health

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Short-Course vs Long-Course Antibiotic Therapy for Children With Nonsevere Community-Acquired Pneumonia

Zhou

Flórez

et al. 2022

JAMA Pediatr

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ImportanceShort-course antibiotic therapy could enhance adherence and reduce adverse drug effects and costs. However, based on sparse evidence, most guidelines recommend a longer course of antibiotics for nonsevere childhood community-acquired pneumonia (CAP).ObjectiveTo determine whether a shorter course of antibiotics was noninferior to a longer course for childhood nonsevere CAP.Data SourcesMEDLINE, Embase, Web of Science, the Cochrane Library, and 3 Chinese databases from inception to March 31, 2022, as well as clinical trial registries and Google.com.Study SelectionRandomized clinical trials comparing a shorter- vs longer-course therapy using the same oral antibiotic for children with nonsevere CAP were included.Data Extraction and SynthesisRandom-effects models were used to pool the data, which were analyzed from April 15, 2022, to May 15, 2022. Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to rate the quality of the evidence.Main Outcomes and MeasuresTreatment failure, defined by persistence of pneumonia or the new appearance of any general danger signs of CAP (eg, lethargy, unconsciousness, seizures, or inability to drink), elevated temperature (&gt;38 °C) after completion of treatment, change of antibiotic, hospitalization, death, missing more than 3 study drug doses, loss to follow-up, or withdrawal of informed consent.ResultsNine randomized clinical trials including 11 143 participants were included in this meta-analysis. A total of 98% of the participants were aged 2 to 59 months, and 58% were male. Eight studies with 10 662 patients reported treatment failure. Treatment failure occurred in 12.8% vs 12.6% of participants randomized to a shorter vs a longer course of antibiotics. High-quality evidence showed that a shorter course of oral antibiotic was noninferior to a longer course with respect to treatment failure for children with nonsevere CAP (risk ratio, 1.01; 95% CI, 0.92-1.11; risk difference, 0.00; 95% CI, –0.01 to 0.01; I2 = 0%). A 3-day course of antibiotic treatment was noninferior to a 5-day course for the outcome of treatment failure (risk ratio, 1.01; 95% CI, 0.91-1.12; I2 = 0%), and a 5-day course was noninferior to a 10-day course (risk ratio, 0.87; 95% CI, 0.50-1.53; I2 = 0%). A shorter course of antibiotics was associated with fewer reports of gastroenteritis (risk ratio, 0.79; 95% CI, 0.66-0.95) and lower caregiver absenteeism (incident rate ratio, 0.74; 95% CI, 0.65-0.84).Conclusions and RelevanceResults of this meta-analysis suggest that a shorter course of antibiotics was noninferior to a longer course in children aged 2 to 59 months with nonsevere CAP. Clinicians should consider prescribing a shorter course of antibiotics for the management of pediatric nonsevere CAP.

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Ambulatory short-course high-dose oral amoxicillin for treatment of severe pneumonia in children: a randomised equivalency trial

Cited by 161 publications

References 26 publications

Treatment Failure of Ampicillin to Children with Pneumonia at Dr. Hasan Sadikin General Hospital Bandung from 2014–2015

Treatment Failure of Ampicillin to Children with Pneumonia at Dr. Hasan Sadikin General Hospital Bandung from 2014–2015

Pharmacokinetics of penicillin antibiotics: intravenous-to-oral switch therapy

Short-Course vs Long-Course Antibiotic Therapy for Children With Nonsevere Community-Acquired Pneumonia

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