Antibiotics for community acquired pneumonia in children

Kabra, S. K.; Lodha, Rakesh; Pandey, Ravindra Mohan

doi:10.1002/14651858.cd004874.pub2

Cited by 48 publications

(50 citation statements)

References 51 publications

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“…These findings are consistent with the reality that most health facilities in Africa have not yet adopted standard treatment guidelines and, even where they exist, adherence may prove to be very low. This is unfortunate, considering that oral amoxicillin, which can be administered at home, has been found to be as effective as parenteral penicillin in treatment of children with uncomplicated severe community-acquired pneumonia without hypoxia [68]. The systematic review by Christopher and colleagues concluded that improved availability of well-trained and motivated community health workers had the potential to reduce childhood mortality rate from malaria, pneumonia, and diarrhea in sub-Saharan Africa by 25-30 % [64].…”

Section: Back To Realitymentioning

confidence: 99%

Better Drug Therapy for the Children of Africa: Current Impediments to Success and Potential Strategies for Improvement

et al. 2013

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A commentary is presented on the urgent need for a comprehensive effort to improve the practice of pediatric therapeutics in Africa. A call for action is addressed to a variety of practitioners internationally, many of whom possess skills that could be fruitfully applied to the improvement of health outcomes for African children. Successful engagement with the many challenges requires the complementary effort of researchers in basic and clinical pharmacology and toxicology, nurses, pharmacists, physicians, clinical pharmacologists, clinical pharmacists, and political leaders and civil servants. While a comprehensive or systematic review of the relevant literature has not been attempted, the authors have highlighted promising initiatives driven by international agencies and academic networks. Two African perspectives are presented to reinforce the prospect of child health gains that can be achieved through consistent pursuit of optimal therapy for conditions such as respiratory infection, diarrhea, malaria, and HIV/AIDS. There is an imperative for development of north-south and south-south partnerships that will amplify current research efforts and mobilize existing knowledge concerning pediatric drugs. The overall goal is a multidisciplinary commitment to making essential medicines available at the right time, the right place, and in the right formulation for African children from infancy to adolescence.

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Section: Back To Realitymentioning

confidence: 99%

Better Drug Therapy for the Children of Africa: Current Impediments to Success and Potential Strategies for Improvement

et al. 2013

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“…Kabra et al 27 Chloramphenicol v. penicillin + gentamicin for communityacquired pneumonia (children)…”

Section: Admission Infectiousmentioning

confidence: 99%

“…Stewart et al 37 Abba et al 20 Okebe et al 31 comparison C Duley et al 48 Kabra et al 27 Humphreys et al 33 comparison A Komossa et al 42 Dodd et al 53 Halliday et al 35 Crowther et al 54 Duley et al 47 Abalos et al 51 comparison A Rumbold et al 56 Cates et al 12 Okebe et al 31 comparison B Buppasiri et al 59 Ducharme et al 11 Martí-Carvajal et al 62 Graves et al 30 Nannini et al 13 Lucero et al 28 Walters et al 21 Peña-Rosas et al 58 Spencer et al 15 Abalos et al 51 comparison B Thomas et al 29 Nannini et al 14 Karner et al 19 Welsh et al 18 King et al 49 Al revic et al 52 Okebe et al 31 comparison D Grimwade et al 24 Rumbold et al 55 Walters et al 9 Halliday et al 36 Soares-Weiser et al 23 Makrides et al 50 Hofmeyr et al 46 Cates et al 16 Cates et al 17 Poole et al 8 Grimwade et al 25 Barr et al 10 Imdad et al 45 Okebe et al …”

Section: Studymentioning

confidence: 99%

Concordance of effects of medical interventions on hospital admission and readmission rates with effects on mortality

Hemkens

Contopoulos‐Ioannidis

Ioannidis

2013

CMAJ

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Research CMAJ Background:Many clinical trials examine a composite outcome of admission to hospital and death, or infer a relationship between hospital admission and survival benefit. This assumes concordance of the outcomes "hospital admission" and "death." However, whether the effects of a treatment on hospital admissions and readmissions correlate to its effect on serious outcomes such as death is unknown. We aimed to assess the correlation and concordance of effects of medical interventions on admission rates and mortality. Methods:We searched the Cochrane Database of Systematic Reviews from its inception to January 2012 (issue 1, 2012) for systematic reviews of treatment comparisons that included meta-analyses for both admission and mortality outcomes. For each meta-analysis, we synthesized treatment effects on admissions and death, from respective randomized trials reporting those outcomes, using random-effects models. We then measured the concordance of directions of effect sizes and the correlation of summary estimates for the 2 outcomes. Results:We identified 61 meta-analyses including 398 trials reporting mortality and 182 trials reporting admission rates; 125 trials reported both outcomes. In 27.9% of comparisons, the point estimates of treatment effects for the 2 outcomes were in opposite directions; in 8.2% of trials, the 95% confidence intervals did not overlap. We found no significant correlation between effect sizes for admission and death (Pearson r = 0.07, p = 0.6). Our results were similar when we limited our analysis to trials reporting both outcomes. Interpretation:In this metaepidemiological study, admission and mortality outcomes did not correlate, and discordances occurred in about one-third of the treatment comparisons included in our analyses. Both outcomes convey useful information and should be reported separately, but extrapolating the benefits of admission to survival is unreliable and should be avoided. Abstract

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“…Between 2004and 2005, the hospitalisation rate for pneumonia in England was 1.98 per 1000 population (Trotter 2008). Complications may include sepsis, meningitis and lung failure resulting in death ( Bjerre 2009;Kabra 2010).…”

Section: B a C K G R O U N D Description Of The Conditionmentioning

confidence: 99%