Can Short Antibiotic Treatment be Widely Used in Developed Countries

Abstract

Childhood pneumonia is the most common killer of children <5 years worldwide. Although in the developed world pneumonia does not commonly result in death, it is an extremely common disease. Treatment is almost universally with antibiotics. However, the lack of appropriate definition of pneumonia, the difficulty in diagnosing the pathogen and cultural differences make it extremely difficult to agree on the ideal treatment. A short antibiotic course is preferred to a longer one, since if equally effective, it should be associated with lower cost, less adverse events and lower rates of antibiotic resistance in the community. An extensive literature search using a combination of the words “pneumonia”, “community-acquired”, “treatment”, “drug”, “antibiotic”, short”, “shortened”, “day (s)”, and “child” resulted in a few articles only dealing with short duration treatment of pneumonia in children, all in the developing world and most dealing with pneumonia defined by the WHO criteria (used in locations where no modern medicine can be applied). We undertook a prospective, double blind, randomized study, comparing high-dose amoxicillin (80 mg/kg) administered for 5 vs. 10 days in children with community-acquired alveolar pneumonia with the following inclusion criteria: 1) <5 years old; 2) radiologically proven alveolar pneumonia; 3) temperature “38.5 °C; 4) peripheral WBC” 15,000/mm3. We followed the children both clinically and with laboratory findings for a month. The study will be unblinded after January 31st and the preliminary results will be presented. In conclusion: Paucity of data and difficulty in defining childhood pneumonia in the developed world result in confusion in regard to short treatment. However, the first studies will reveal, at least in some defined subgroups of pneumonia, the efficacy and the potential use of short-course treatment in childhood pneumonia. Abstracts for SupplementInternational Journal of Infectious DiseasesVol. 14Preview Full-Text PDF Open Archive