Children's Health Defense The Defenderâs Weekly Science Digest delivers a roundup of the latest research on childrenâs health, including studies on vaccines, drugs, chemicals, pesticides and lead exposure.
Are antibiotics for childhood pneumonia overprescribed?
Interpretation of Antibiotic Trials in Pediatric Pneumonia;Â JAMA Network Open, Feb. 2, 2024.
Clinicians have been baffled by studies suggesting that neither the intensity nor duration of antibiotic treatment in kids with pneumonia affected outcomes.
A Harvard and Boston Childrenâs Hospital research letter suggests the problem with those studies was that many of those children did not have pneumonia.
To demonstrate this, investigators enrolled 1,252 children, ages 3 months to 6 years, of whom 507 met inclusion criteria for the CAP-IT Trial, meaning they would normally receive antibiotics.
This study, on amoxicillin treatment for pediatric pneumonia, included subjects who had all of the following: cough within the previous four days, fever within the previous two days, and either labored breathing, focal chest signs or lobar pneumonia.
These criteria are typically assessed through clinical judgment, not X-rays.
When those 507 CAP-IT-eligible patients were X-rayed, just 154 (30%) had pneumonia and 49 (10%) had possible pneumonia. The remaining 304 (60%), who did not have X-ray-confirmed pneumonia, did fine without treatment.
This led investigators to conclude that nearly half of children prescribed antibiotics for pneumonia recover without the medication, and that future antibiotic prescriptions should be based on X-ray confirmation.
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