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Medicos should narrow their aim in treating child pneumonia

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Narrow-spectrum antibiotics are just as effective in treating children with pneumonia as their broad-spectrum counterparts, a United States study has found.

The findings confirm the recommendations of the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America that narrow-spectrum antibiotics such as ampicillin or penicillin G should be used as first-line treatments for children hospitalised with the condition.

The research team from the University of Missouri School of Medicine set out to test the scientific evidence which underpinned the recommendation in favour of using narrow-spectrum antibiotics for children with pneumonia.

Broad-spectrum antibiotics act against a wider range of bacteria than narrow-spectrum antibiotics, but have the undesirable side-effect of adversely affecting a broader range of healthy bacteria in the body.

“The objective was to compare the effectiveness of empiric treatment with narrow-spectrum therapy versus broad-spectrum therapy for children hospitalised with uncomplicated community-acquired pneumonia (CAP),” they said in a report published in Pediatrics medical journal.

They gathered medical records from children aged from two months to 18 years at four children’s hospitals who had been discharged in 2010 with a diagnosis of pneumonia.

Among 492 patients studied, 52 per cent were treated with a narrow-spectrum antibiotic and 48 per cent with a broad-spectrum agent.

They found there was no significant difference between the narrow-spectrum and broad-spectrum groups in duration of oxygen use, duration of fever or readmission rate within seven days of discharge. There was also no difference between the groups in terms of the cost of treatment.

“Compared with broad-spectrum agents, narrow-spectrum antibiotic coverage is associated with similar outcomes,” they said.

“Our findings support national consensus recommendations for the use of narrow-spectrum antibiotics in children hospitalised with CAP.”

Lead author Dr Mary Ann Queen told Reuters news agency that the study’s findings indicated that doctors and some hospitals had yet to reliably change their practice in line with the recommendation in favour of narrow-spectrum antibiotics for children with pneumonia.

“Clinicians should feel confident that narrow-spectrum therapy produces similar outcomes for otherwise healthy children hospitalised with uncomplicated community acquired pneumonia,” she told Reuters.

Debra Vermeer