Chest radiograph in acute respiratory infections in children.

Abstract

Chest radiography is widely used in acute lower respiratory infection in children, but the benefits are unknown. To assess the effects of chest radiography for children with acute lower respiratory infections. We searched the Cochrane Respiratory Infections Group trials register, the Cochrane Controlled Trials Register and MEDLINE up to December 1999. We contacted experts in the fields of acute respiratory infections and paediatric radiology to locate additional studies. Randomised or quasi-randomised trials of chest radiography in acute respiratory infections in children. One reviewer extracted data and assessed trial quality. We identified only one trial of 522 participants, performed by the reviewers. The participants were ambulatory children aged two months to five years. Forty six percent of both radiography and control participants had recovered by seven days - odds ratio (1.03, 95% confidence interval 0.64 to 1.64). Thirty three percent of radiography participants and 32% of control participants made a subsequent hospital visit within four weeks - odds ratio 1.02 (95% confidence interval 0.71 to 1.48). Three percent of both radiography and control participants were subsequently admitted to hospital within four weeks - odds ratio 1.02 (95% confidence interval 0.40 to 2.60). There were no deaths in either group. There is no evidence that chest radiography improves outcome in ambulatory children with acute lower respiratory infection. The findings do not exclude a potential effect of radiography, but the potential benefit needs to be balanced against the hazards and expense of chest radiography. The findings apply to ambulatory children only.