Should fast breathing pneumonia cases be treated with antibiotics? The scientific rationale for revisiting management in Low and Middle income countries

Jehan, Fyezah; Nisar, Imran; Kerai, Salima; Brown, Nick; Ambler, Gwen; Zaidi, Anita K. M.

doi:10.1016/j.ijid.2019.05.035

Cited by 6 publications

(4 citation statements)

References 22 publications

(27 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…They should be treated at home for five days with oral amoxicillin and, in areas of low HIV prevalence and with limited resources, the duration of treatment for ‘fast breathing pneumonia’ can be decreased to three days [ 24 ]. However, the majority of children with ‘fast breathing pneumonia’ have viral, mild, and self-limiting illness [ 25 ]. Isolated tachypnea may not be sensitive or specific enough to diagnose bacterial pneumonia, making antibiotic treatment unnecessary [ 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

Antibiotic Prescribing for Lower Respiratory Tract Infections and Community-Acquired Pneumonia: An Italian Pediatric Emergency Department’s Real-Life Experience

Pierantoni,

Lasala,

Dondi

et al. 2023

Life

View full text Add to dashboard Cite

Lower respiratory tract infections (LRTIs) and community-acquired pneumonia (CAP) are among the most frequent reasons for referrals to the pediatric emergency department (PED). The aim of this study is to describe the management of antibiotic prescription in febrile children with LRTI or CAP admitted to a third-level PED and to investigate the different variables that can guide physicians in this decision-making. Methods: This is an observational, retrospective, monocentric study including patients <14 years old who were presented to the PED for a febrile LRTI or CAP during the first six months of the year 2017. Demographic and clinical data, PED examinations, recommended therapy, and discharge modality were considered. Two multivariate logistic regression analyses were performed on patients with complete profiles to investigate the impact of demographic, laboratory, and clinical variables on antibiotic prescription and hospital admission. Results: This study included 584 patients with LRTI (n = 368) or CAP (n = 216). One hundred and sixty-eight individuals (28.7%) were admitted to the hospital. Lower age, higher heart rate, and lower SpO2 were associated with an increased risk of hospitalization. Antibiotics were prescribed to 495 (84.8%) patients. According to the multivariate logistic regression, the diagnosis and duration of fever were substantially linked with antibiotic prescription. Conclusions: The present study reports real-life data about our PED experience. A high rate of antibiotic prescription was noted. In the future, it is necessary to improve antibiotic stewardship programs to increase clinical adherence to guidelines.

show abstract

Section: Discussionmentioning

confidence: 99%

Antibiotic Prescribing for Lower Respiratory Tract Infections and Community-Acquired Pneumonia: An Italian Pediatric Emergency Department’s Real-Life Experience

Pierantoni,

Lasala,

Dondi

et al. 2023

Life

View full text Add to dashboard Cite

show abstract

“…However, the abuse of antibiotics has led to many safety problems, as they can easily cause liver and kidney damage, gastrointestinal tract symptoms and allergic reactions. Moreover, large doses for long periods can cause drug resistance, resulting in some refractory infections (Jehan et al 2019). TCM is based on the human body's dialectical treatment and the combination of multiple flavours of herbs to treat diseases.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, large doses for long periods can cause drug resistance, resulting in some refractory infections (Jehan et al. 2019 ). TCM is based on the human body's dialectical treatment and the combination of multiple flavours of herbs to treat diseases.…”

Section: Discussionmentioning

confidence: 99%

Protective effects of Re-yan-ning mixture on Streptococcus pneumonia in rats based on network pharmacology

Han

Jing

et al. 2021

Pharmaceutical Biology

View full text Add to dashboard Cite

Context: Re-yan-ning mixture (RYNM) is a new national drug approved by China's State Food and Drug Administration for the treatment of colds, simple pneumonia and acute bronchitis. Objective: To determine the mechanism of action of RYNM in the treatment of bacterial pneumonia. Materials and methods: Using the network pharmacology approach, the multiple components, component candidate targets and multiple therapeutic targets of RYNM were screened and functionally enriched. Also, we established a rat Streptococcus pneumonia model to verify the results of network pharmacology enrichment analysis. Forty male SPF Sprague Dawley rats were divided into four groups of 10 rats: control (normal saline), model (normal saline), levofloxacin-intervened and RYNM-intervened groups. IL-10, NOS2, COX-1, IL-6, TNF-a and NF-jB in serum and BALF were detected by ELISA. Western blot detected IL-17, IL-6, TNF-a, COX-2 and Bcl-2. Results: The network pharmacology approach successfully identified 48 bioactive components in RYNM, and 65 potential targets and 138 signal pathways involved in the treatment of Streptococcus pneumonia with RYNM. The in vivo experiments indicated that model group has visible inflammation and lesions while RYNM and levofloxacin groups have not. The RYNM exhibited its therapeutic effects on Streptococcus pneumonia mainly via the regulation of cell proliferation and survival through the IL-6/IL-10/IL-17, Bax/Bcl-2, COX-1/COX-2, NF-jB and TNF-a signalling pathways. Discussion and conclusions: The present study demonstrated the protective effects of RYNM on Streptococcus pneumonia, providing a potential mechanism for the treatment of bacterial pneumonia with RYNM.

show abstract

“…All previously randomised participants were eligible for inclusion in the nested case–control study A case was defined as a child previously randomised who represented with a recurrent episode of isolated fast breathing between 8 weeks and 1 year of the initial episode. Eight week was considered sufficient wash-out period for resolution of prior episode of fast breathing and the endpoint of a year was chosen for consistency with hospital studies of recurrent pneumonia 19–21…”

Section: Methodsmentioning

confidence: 99%

Recurrence of WHO-defined fast breathing pneumonia among infants, its occurrence and predictors in Pakistan: a nested case–control analysis

et al. 2020

Self Cite

View full text Add to dashboard Cite

ObjectivesStudies in low-income and middle-income countries have shown an adverse association between environmental exposures including poverty. There is little literature from South Asia. We aimed to test the associations between housing, indoor air pollution and children’s respiratory health and recurrent fast breathing pneumonia in a poor urban setting in Pakistan.SettingPrimary health centres in a periurban slum in Karachi, Pakistan.MethodsNested matched case–control study within a non-inferiority randomised controlled trial of fast breathing pneumonia (Randomised Trial of Amoxicillin vs Placebo for Pneumonia (RETAPP)) in periurban slums of Karachi, Pakistan. Cases were children aged 2–60 months enrolled in RETAPP with fast breathing pneumonia who presented again with fast breathing between 8 weeks and 12 months after full recovery. Controls, selected in a 2:1 ratio, were age-matched participants who did not represent. Multivariable conditional logistic regression analysis was undertaken to explore associations with potentially modifiable environmental predictors including housing type, indoor air quality, exposure to tobacco smoke, outdoor pollution, household crowding, water and sanitation quality, nutritional status, immunisation completeness, breast feeding and airways hyperactivity.ResultsFast breathing recurred in 151 (3.7%) of children out of the total (4003) enrolled in the trial. Poor-quality housing of either katcha or mixed type strongly predicted recurrence with adjusted matched ORs 2.43 (95% CI 1.02 to 5.80) and 2.44 (1.11 to 5.38), respectively. Poor air quality, cooking fuel, inadequate ventilation, nutritional status, water, sanitation and hygiene (WASH) index, wheeze at first presentation and group of initial trial assignment were not independently predictive of recurrence.ConclusionPoor-quality housing independently predicted recurrence of fast breathing pneumonia.Trial registration numberNCT02372461

show abstract

Should fast breathing pneumonia cases be treated with antibiotics? The scientific rationale for revisiting management in Low and Middle income countries

Cited by 6 publications

References 22 publications

Antibiotic Prescribing for Lower Respiratory Tract Infections and Community-Acquired Pneumonia: An Italian Pediatric Emergency Department’s Real-Life Experience

Antibiotic Prescribing for Lower Respiratory Tract Infections and Community-Acquired Pneumonia: An Italian Pediatric Emergency Department’s Real-Life Experience

Protective effects of Re-yan-ning mixture on Streptococcus pneumonia in rats based on network pharmacology

Recurrence of WHO-defined fast breathing pneumonia among infants, its occurrence and predictors in Pakistan: a nested case–control analysis

Contact Info

Product

Resources

About