Duration of antibiotics for community‐acquired pneumonia in young children

Abstract

“Pneumonia affects millions of children around the world each year, causing several hundred thousand deaths. It is the largest killer of children living in low-income countries. Having reliable knowledge about interventions and therapies that might affect pneumonia is vital for any effort to improve child survival. Curing pneumonia requires an effective antibiotic at an adequate dose and for an appropriate length of time. Antibiotics are being widely used but there is uncertainty about how long to use these drugs for. In most cases, treatment usually goes on for 7 to 14 days, but this is not based on empirical evidence. Our Cochrane Review aimed to study the effect of a shorter duration of antibiotic therapy for pneumonia in children up to 5 years of age and to evaluate if a shorter course produces the same result as a longer course of therapy. This is very important in the context of resource-poor settings where there is a high risk of death, poor access to drugs and health care, and relatively little money for medicines. Shorter courses of antibiotic therapy might also make it more likely that children will take the whole course and could lead to less antimicrobial resistance and lower costs. We found three studies: one from India, one from Pakistan, and one from Indonesia and Bangladesh. These had randomized a total of 6200 children suffering from pneumonia, but we were able to use the data of around 5800 children only. All three trials compared three days of treatment against five days. Our analysis showed that the two durations had very similar outcomes. The extra two days did not make a difference. The short course was as effective as the longer course, with no differences in terms of the rates of clinical cure at the end of treatment, treatment failure, and relapse within seven days of clinical cure.” This Cochrane Review is available in full as Haider BA, Saeed MA, Bhutta ZA. Short-course versus long-course antibiotic therapy for non-severe community-aquired pneumonia in children aged 2 months to 59 months. Cochrane Database of Systematic Reviews 2008, Issue 2. Art. No.: CD005976. DOI: 10.1002/14651858.CD005976.pub2.