The quality of evidence is downgraded by study limitations (unclear allocation concealment and lack of blinding).
A Cochrane review [Abstract] 1 included 4 studies with a total of 1 314 children with undifferentiated acute respiratory infections (ARIs). ARIs are large and varied groups of infections that are not clearly restricted to one specific part of the upper respiratory tract; they last for up to 7 days. This review examined the use of antibiotics to prevent clinical bacterial complications in children up to 5 years of age with undifferentiated ARIs and cough. Three studies investigated the use of amoxicillin/clavulanic acid to prevent otitis and one investigated ampicillin to prevent pneumonia.
The use of amoxicillin/clavulanic acid compared to placebo to prevent otitis showed a risk ratio (RR) of 0.70 (95% CI 0.45 to 1.11, 3 studies, n=414). Ampicillin compared to supportive care (continuation of breastfeeding, clearing of the nose and paracetamol for fever control) to prevent pneumonia showed a RR of 1.05 (95% CI 0.74 to 1.49, 1 study, n=889). Harm outcomes could not be analysed. No studies were found assessing mastoiditis, quinsy, abscess, meningitis, hospital admission or death.
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