Comparison of Different Antibiotics for Community Acquired Pneumonia in Children

Summary

A Cochrane review [Abstract] 1 included 29 studies with a total of 14 188 children comparing multiple antibiotics. None compared antibiotics with placebo. Most of the studies were conducted in developing countries. For ambulatory treatment of non-severe community acquired pneumonia (CAP), amoxycillin compared with co-trimoxazole (3 studies, n=3 952) had similar failure rates (OR 1.18, 95% CI 0.91 to 1.51) and cure rates (OR 1.03, 95% CI 0.56 to 1.89). In children with severe pneumonia without hypoxaemia, oral antibiotics (amoxycillin/co-trimoxazole) compared with injectable penicillin (6 studies, n=4 331) had similar failure rates (OR 0.84, 95% CI 0.56 to 1.24), hospitalisation rates (OR 1.13, 95% CI 0.38 to 3.34) and relapse rates (OR 1.28, 95% CI 0.34 to 4.82). In very severe CAP death rates seemed to be higher in children receiving chloramphenicol compared to those receiving penicillin/ampicillin plus gentamicin (OR 1.25, 95% CI 0.76 to 2.07; 1 study, n=1 116) although the difference was not statistically significant.