Antibiotics for preventing suppurative complications from undifferentiated acute respiratory infections in children under five years of age

Galvão, Márcia G Alves; Santos, Marilene Augusta Rocha Crispino; Cunha, Antônio José Lêdo Alves da

doi:10.1002/14651858.cd007880.pub3

Cited by 19 publications

(8 citation statements)

References 87 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…28 A 2016 Cochrane review assessing antibiotic treatment of undifferentiated acute respiratory infection in children less than 5 years of age found that there is insufficient evidence for antibiotic use as a means of preventing suppurative complications, such as pneumonia. 29 In the United States, clinical practice guidelines established by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America note that, for outpatients, “antimicrobial therapy is not routinely required for preschool-aged children with community-acquired pneumonia, because viral pathogens are responsible for the great majority of clinical disease (strong recommendation; high-quality evidence).” 30 (pe30) While Haemophilus influenzae type b (Hib) and pneumococcal conjugate vaccines are being scaled up—the Hib conjugate vaccine was introduced in Malawi in 2002 as part of the Expanded Programme for Immunization, and the pneumococcal conjugate vaccine was added to the national strategy in 2011—the etiology and epidemiology of community-acquired pneumonia is changing. For example, a recent pneumococcal conjugate vaccine effectiveness study in Malawi found a reduction in the severest forms of clinical and hypoxemic pneumonia alongside a seemingly paradoxical increase in fast-breathing pneumonia cases.…”

Section: Discussionmentioning

confidence: 99%

Placebo vs Amoxicillin for Nonsevere Fast-Breathing Pneumonia in Malawian Children Aged 2 to 59 Months

Ginsburg

Mvalo²,

Nkwopara

et al. 2019

JAMA Pediatr

View full text Add to dashboard Cite

Key Points Question Are antibiotics necessary for the treatment of nonsevere fast-breathing pneumonia in children? Findings In this double-blind, randomized clinical noninferiority trial that included 1126 HIV-uninfected children aged 2 to 59 months in a malaria-endemic region of Malawi, Africa, placebo treatment of nonsevere fast-breathing pneumonia was significantly inferior to 3 days of amoxicillin treatment with respect to treatment failure at day 4. Fast-breathing pneumonia resolved by day 4 in 93% of children without the use of the antibiotic. Meaning Without amoxicillin treatment, 7% of Malawian children with nonsevere fast-breathing pneumonia failed treatment by day 4, and treating 33 children with amoxicillin was necessary for 1 child to benefit.

show abstract

Section: Discussionmentioning

confidence: 99%

Placebo vs Amoxicillin for Nonsevere Fast-Breathing Pneumonia in Malawian Children Aged 2 to 59 Months

Ginsburg

Mvalo²,

Nkwopara

et al. 2019

JAMA Pediatr

View full text Add to dashboard Cite

show abstract

“…[ 59 , 60 ] A systematic study showed that there is insufficient evidence for antibiotic use as a means of reducing the risk of both URTI and LRTI. [ 61 ] It is very important to decrease the incidence of new episodes of RTIs, shorten the duration time, and reduce symptoms. In this systematic review, we showed that probiotic supplementation could decrease the number of subjects with at least 1 RTI episode and duration of illness.…”

Section: Discussionmentioning

confidence: 99%

Probiotics for prevention and treatment of respiratory tract infections in children

Wang¹,

Li²,

Ge³

et al. 2016

Medicine

180

125

View full text Add to dashboard Cite

show abstract

“…Examining prescriptions for childhood upper respiratory infections (URI) is a commonly accepted strategy to evaluate rationality of antibiotic use, as most URI are viral where antibiotics do not shorten the duration of the URI or prevent complications [10]. However, antibiotic prescribing for childhood URI is still often seen in practice, ranging from 20–90% [11], the highest rates being reported in Africa and Asia [11,12].…”

Section: Introductionmentioning

confidence: 99%

Antibiotic prescribing for upper respiratory infections among children in rural China: a cross-sectional study of outpatient prescriptions

Zhang¹,

Zou

et al. 2017

Global Health Action

View full text Add to dashboard Cite

Background: Overuse of antibiotics contributes to the development of antimicrobial resistance.Objective: This study aims to assess the condition of antibiotic use at health facilities at county, township and village levels in rural Guangxi, China.Methods: We conducted a cross-sectional study of outpatient antibiotic prescriptions in 2014 for children aged 2–14 years with upper respiratory infections (URI). Twenty health facilities were randomly selected, including four county hospitals, eight township hospitals and eight village clinics. Prescriptions were extracted from the electronic records in the county hospitals and paper copies in the township hospitals and village clinics.Results: The antibiotic prescription rate was higher in township hospitals (593/877, 68%) compared to county hospitals (2736/8166, 34%) and village clinics (96/297, 32%) (p < 0.001). Among prescriptions containing antibiotics, county hospitals were found to have the highest use rate of broad-spectrum antibiotics (82 vs 57% [township], vs 54% [village], p < 0.001), injectable antibiotics (65 vs 43% [township], vs 33% [village], p < 0.001) and multiple antibiotics (47 vs 15% [township], vs 0% [village], p < 0.001). Logistic regression showed that the likelihood of prescribing an antibiotic was significantly associated with patients being 6–14 years old compared with being 2–5 years old (adjusted odds ratio [aOR] = 1.3, 95% CI 1.2–1.5), and receiving care at township hospitals compared with county hospitals (aOR = 5.0, 95% CI 4.1–6.0). Prescriptions with insurance copayment appeared to lower the risk of prescribing antibiotics compared with those without (aOR = 0.8, 95% CI 0.7–0.9).Conclusions: Inappropriate use of antibiotics was high for outpatient childhood URI in the four counties of Guangxi, China, with the highest rate found in township hospitals. A significant high proportion of prescriptions containing antibiotics were broad-spectrum, by intravenous infusion or with multiple antibiotics, especially at county hospitals. Urgent attention is needed to address this challenge.

show abstract

Antibiotics for preventing suppurative complications from undifferentiated acute respiratory infections in children under five years of age

Cited by 19 publications

References 87 publications

Placebo vs Amoxicillin for Nonsevere Fast-Breathing Pneumonia in Malawian Children Aged 2 to 59 Months

Placebo vs Amoxicillin for Nonsevere Fast-Breathing Pneumonia in Malawian Children Aged 2 to 59 Months

Probiotics for prevention and treatment of respiratory tract infections in children

Antibiotic prescribing for upper respiratory infections among children in rural China: a cross-sectional study of outpatient prescriptions

Contact Info

Product

Resources

About