For young children with undifferentiated acute respiratory infections (ARIs), current evidence does not support the use of antibiotics to prevent ear infections or pneumonia, according to a review published online Feb. 18 in The Cochrane Library.
Márcia G. Alves Galvão, Ph.D., from the Municipal Secretariat of Health in Rio de Janeiro, and colleagues conducted a systematic literature review to examine the effectiveness of antibiotics in preventing complications in children aged 2 to 59 months with undifferentiated ARIs. Data were reviewed from four randomized controlled trials (RCTs) or quasi-RCTs, involving 1,314 children with an undifferentiated ARI to compare antibiotic prescriptions with placebo or non-treatment.
The researchers found that in three trials, involving 414 selected children, with moderate-quality evidence, the use of amoxicillin/clavulanic acid versus placebo to prevent otitis demonstrated a risk ratio (RR) of 0.70 (95 percent confidence interval [CI], 0.45 to 1.11). Based on one trial involving 889 selected children, with moderate-quality evidence, the use of ampicillin compared with supportive care to prevent pneumonia showed a RR of 1.05 (95 percent CI, 0.74 to 1.49).
“The quality of evidence currently available does not provide strong support for antibiotic use as a means of reducing the risk of otitis or pneumonia in children up to 5 years of age with undifferentiated ARIs,” the authors write.
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