Oral amoxicillin compared with injectable procaine benzylpenicillin plus gentamicin for treatment of neonates and young infants with fast breathing when referral is not possible: a randomised, open-label, equivalence trial

Tshefu, Antoinette; Lokangaka, Adrien; Ngaima, Serge; Engmann, Cyril; Esamai, Fabian; Gisore, Peter; Ayede, Adejumoke Idowu; Falade, Adegoke G; Adejuyigbe, Ebunoluwa A.; Anyabolu, Chineme Henry; Wammanda, Robinson D.; Ejembi, Clara Ladi; Ogala, WN; Gram, Lu; Cousens, Simon

doi:10.1016/s0140-6736(14)62285-6

Cited by 73 publications

(73 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…New WHO guidelines on antibiotic management of neonatal infections have been released based on the results of the Simplified Antibiotic Therapy Trial 33, 34, 35, 36. These guidelines could further encourage community treatment and reduce mortality from neonatal infections.…”

Section: Discussionmentioning

confidence: 99%

Global, regional, and national causes of under-5 mortality in 2000–15: an updated systematic analysis with implications for the Sustainable Development Goals

et al. 2016

Self Cite

View full text Add to dashboard Cite

SummaryBackgroundDespite remarkable progress in the improvement of child survival between 1990 and 2015, the Millennium Development Goal (MDG) 4 target of a two-thirds reduction of under-5 mortality rate (U5MR) was not achieved globally. In this paper, we updated our annual estimates of child mortality by cause to 2000–15 to reflect on progress toward the MDG 4 and consider implications for the Sustainable Development Goals (SDG) target for child survival.MethodsWe increased the estimation input data for causes of deaths by 43% among neonates and 23% among 1–59-month-olds, respectively. We used adequate vital registration (VR) data where available, and modelled cause-specific mortality fractions applying multinomial logistic regressions using adequate VR for low U5MR countries and verbal autopsy data for high U5MR countries. We updated the estimation to use Plasmodium falciparum parasite rate in place of malaria index in the modelling of malaria deaths; to use adjusted empirical estimates instead of modelled estimates for China; and to consider the effects of pneumococcal conjugate vaccine and rotavirus vaccine in the estimation.FindingsIn 2015, among the 5·9 million under-5 deaths, 2·7 million occurred in the neonatal period. The leading under-5 causes were preterm birth complications (1·055 million [95% uncertainty range (UR) 0·935–1·179]), pneumonia (0·921 million [0·812 −1·117]), and intrapartum-related events (0·691 million [0·598 −0·778]). In the two MDG regions with the most under-5 deaths, the leading cause was pneumonia in sub-Saharan Africa and preterm birth complications in southern Asia. Reductions in mortality rates for pneumonia, diarrhoea, neonatal intrapartum-related events, malaria, and measles were responsible for 61% of the total reduction of 35 per 1000 livebirths in U5MR in 2000–15. Stratified by U5MR, pneumonia was the leading cause in countries with very high U5MR. Preterm birth complications and pneumonia were both important in high, medium high, and medium child mortality countries; whereas congenital abnormalities was the most important cause in countries with low and very low U5MR.InterpretationIn the SDG era, countries are advised to prioritise child survival policy and programmes based on their child cause-of-death composition. Continued and enhanced efforts to scale up proven life-saving interventions are needed to achieve the SDG child survival target.FundingBill & Melinda Gates Foundation, WHO.

show abstract

Section: Discussionmentioning

confidence: 99%

Global, regional, and national causes of under-5 mortality in 2000–15: an updated systematic analysis with implications for the Sustainable Development Goals

et al. 2016

Self Cite

View full text Add to dashboard Cite

show abstract

“…[4]In Nigeria, the AFRINEST study showed that over 10% of live birth will develop PSBI. [5][6] The standard practice to manage young infants with any sign of PSBI is in a hospital setting with parenteral antibiotics, which may not be feasible in low resource settings, especially in some low-and middle-income countries (LMIC). Simplified regimens comprising of injectable plus oral antibiotics delivered outside the hospital setting when referral was not feasible, were shown to be effective by Bang et al in India, [7] Baqui et al in Bangladesh [8]and Zaidi et al in Pakistan [9].…”

Section: Introductionmentioning

confidence: 99%

Implementation of the WHO guideline on treatment of young infants with signs of possible serious bacterial infection when hospital referral is not feasible in rural Zaria, Nigeria: Challenges and solutions

et al. 2020

View full text Add to dashboard Cite

Background Bacterial infection is one of the leading causes of mortality in young infants globally. The standard practice to manage young infants with any sign of possible serious bacterial infection (PSBI) is in a hospital setting with parenteral antibiotics, which may not be feasible for majority of cases in most low resource settings. The World Health Organization developed a guideline on management of PSBI in young infants when referral is not feasible in 2016. Methods We conducted implementation research in selected communities in Zaria Local Government Areas of Kaduna State with an estimated population of 50,000 with the aim of understanding how to implement the WHO PSBI treatment guideline to achieve high coverage with low case fatality and treatment failure rates. Implementation was within the programmatic settings using existing health structure. We conducted policy dialogue with decision makers to adapt the recommendations to their social, cultural and programmatic context in Nigeria, held orientation meetings with program managers, built capacity of the health workers and supported the implementation within the health system. We supported a non-government organization to conduct community sensitization to promote care seeking and adherence to treatment advice. The research team collected data systematically on all young infants identified to have PSBI, the treatment they received and the clinical outcome.

show abstract

“…Based on new evidence from the African Neonatal Sepsis Trial (AFRINEST) and the Simplified Antibiotic Therapy Trial (SATT), 8 – 10 the World Health Organization (WHO) recently provided guidelines for the treatment of possible severe bacterial infections (PSBIs) in infants where referral to hospital is not feasible 11 . These guidelines recommend that trained health care providers give outpatient treatment for newborns and young infants 0–59 days of age with PSBI using simplified regimens; for infants with clinical severe infection, the recommended regimen is injectable gentamicin plus oral amoxicillin, and for infants with isolated rapid breathing, oral amoxicillin only.…”

Section: Introductionmentioning

confidence: 99%

Effect on Neonatal Mortality of Newborn Infection Management at Health Posts When Referral Is Not Possible: A Cluster-Randomized Trial in Rural Ethiopia

Hailegebriel

Mulligan

Mathewos

et al. 2017

Glob Health Sci Pract

Self Cite

View full text Add to dashboard Cite

Health Extension Workers (HEWs), in general, properly provided antibiotic treatment of possible severe bacterial infections in newborns at the health post level. But only about half of newborns estimated to have infections in the intervention area received treatment by HEWs, and home visits and referrals declined in the final months of the study. Cluster-level analysis suggests a mortality reduction consistent with this level of treatment coverage, although the finding did not reach statistical significance.

show abstract

Oral amoxicillin compared with injectable procaine benzylpenicillin plus gentamicin for treatment of neonates and young infants with fast breathing when referral is not possible: a randomised, open-label, equivalence trial

Cited by 73 publications

References 19 publications

Global, regional, and national causes of under-5 mortality in 2000–15: an updated systematic analysis with implications for the Sustainable Development Goals

Global, regional, and national causes of under-5 mortality in 2000–15: an updated systematic analysis with implications for the Sustainable Development Goals

Implementation of the WHO guideline on treatment of young infants with signs of possible serious bacterial infection when hospital referral is not feasible in rural Zaria, Nigeria: Challenges and solutions

Effect on Neonatal Mortality of Newborn Infection Management at Health Posts When Referral Is Not Possible: A Cluster-Randomized Trial in Rural Ethiopia

Contact Info

Product

Resources

About