Antibiotics for Childhood Pneumonia — Do We Really Know How Long to Treat?

Chang, Anne B.; Grimwood, Keith

doi:10.1056/nejme2016328

Cited by 11 publications

(14 citation statements)

References 9 publications

(7 reference statements)

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“…Moreover, it is proposed to increase the insuffi cient eff ectiveness of this type of medical care by extending treatment courses to achieve a sterilizing eff ect (?) and reduce the long-term consequences of lung tissue infl ammation [6]. Such recommendations only raise additional questions, since it is known that it is impossible to achieve complete sterility of a living organism even theoretically, and antibiotics act exclusively on microorganisms, but do not directly aff ect the mechanisms of infl ammatory response in tissues.…”

Section: American Journal Of Emergency and Critical Care Medicinementioning

confidence: 99%

Untitled

2020

American Journal of Emergency & Critical Care Medicine

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Section: American Journal Of Emergency and Critical Care Medicinementioning

confidence: 99%

Untitled

2020

American Journal of Emergency & Critical Care Medicine

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“…Whilst the global mortality of childhood ALRIs has declined ( 1 ), morbidity and long-term outcomes of ALRIs remain an important public health issue. ALRIs risk injuring the developing lung, which may lead to subsequent impaired lung growth and function ( 4 , 5 ) and predispose children to chronic lung disease ( 6 ). Our previous international cohort ( 7 ) study found that early-onset ALRI requiring hospitalisation (first episode occurred at median age of 3.7-months) was an independent risk factor for bronchiectasis.…”

Section: Introductionmentioning

confidence: 99%

Study Protocol for Preventing Early-Onset Pneumonia in Young Children Through Maternal Immunisation: A Multi-Centre Randomised Controlled Trial (PneuMatters)

et al. 2022

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Background: Preventing and/or reducing acute lower respiratory infections (ALRIs) in young children will lead to substantial short and long-term clinical benefits. While immunisation with pneumococcal conjugate vaccines (PCV) reduces paediatric ALRIs, its efficacy for reducing infant ALRIs following maternal immunisation has not been studied. Compared to other PCVs, the 10-valent pneumococcal-Haemophilus influenzae Protein D conjugate vaccine (PHiD-CV) is unique as it includes target antigens from two common lower airway pathogens, pneumococcal capsular polysaccharides and protein D, which is a conserved H. influenzae outer membrane lipoprotein.Aims: The primary aim of this randomised controlled trial (RCT) is to determine whether vaccinating pregnant women with PHiD-CV (compared to controls) reduces ALRIs in their infants' first year of life. Our secondary aims are to evaluate the impact of maternal PHiD-CV vaccination on different ALRI definitions and, in a subgroup, the infants' nasopharyngeal carriage of pneumococci and H. influenzae, and their immune responses to pneumococcal vaccine type serotypes and protein D.Methods: We are undertaking a parallel, multicentre, superiority RCT (1:1 allocation) at four sites across two countries (Australia, Malaysia). Healthy pregnant Australian First Nation or Malaysian women aged 17–40 years with singleton pregnancies between 27+6 and 34+6 weeks gestation are randomly assigned to receive either a single dose of PHiD-CV or usual care. Treatment allocation is concealed. Study outcome assessors are blinded to treatment arms. Our primary outcome is the rate of medically attended ALRIs by 12-months of age. Blood and nasopharyngeal swabs are collected from infants at birth, and at ages 6- and 12-months (in a subset). Our planned sample size (n = 292) provides 88% power (includes 10% anticipated loss to follow-up).Discussion: Results from this RCT potentially leads to prevention of early and recurrent ALRIs and thus preservation of lung health during the infant's vulnerable period when lung growth is maximum. The multicentre nature of our study increases the generalisability of its future findings and is complemented by assessing the microbiological and immunological outcomes in a subset of infants.Clinical Trial Registration:https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374381, identifier: ACTRN12618000150246.

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“…In recent years, the tactics of antibacterial therapy have suddenly and insufficiently reasoned changed with the recommendation of short (up to 3-5 days) courses of AP treatment, but this did not affect the results. [13][14][15][16] Despite the fact that the leading role of antibiotics in the treatment of AP has long caused dissatisfaction with the final results, and various tactics of their use do not bring success, the commitment to the old dogmas remains tragically unshakeable. In the current conditions with a large number of cases of COVID-19 pneumonia, when the use of antibiotics makes neither logic nor sense, professional recommendations to continue prescribing them to these patients are surprising.…”

mentioning

confidence: 99%

First aid for acute lung inflammation

Klepikov¹

2021

JLPRR

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Antibiotics for Childhood Pneumonia — Do We Really Know How Long to Treat?

Cited by 11 publications

References 9 publications

Untitled

Untitled

Study Protocol for Preventing Early-Onset Pneumonia in Young Children Through Maternal Immunisation: A Multi-Centre Randomised Controlled Trial (PneuMatters)

First aid for acute lung inflammation

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