A Cochrane review [Abstract]1 included 7 studies with a total of 1 263 children. Pooled study data showed that the incidence of pneumonia was lower in the antibiotic treatment group (4.1%) compared to the control group (9.6%) but not statistically significantly (OR 0.35, 95% CI 0.12 to 1.01). One trial conducted in 1942 comparing oral sulfathiazole with symptomatic treatment showed an increase in the rate of pneumonia with antibiotics. If the results of this trial were removed from the meta-analysis, there was a statistically significant reduction in the incidence of pneumonia in children receiving antibiotics (OR 0.26, 95% CI 0.12 to 0.60; NNT to prevent one episode of pneumonia 18). The incidence of other complications was significantly lower in children receiving antibiotics: purulent otitis media (OR 0.34; 95% CI 0.16 to 0.73) and tonsillitis (OR 0.08; 95% CI 0.01 to 0.72). There was no difference in the incidence of conjunctivitis (OR 0.39; 95% CI 0.15 to 1.0), diarrhea (OR 0.53; 95% CI 0.23 to 1.22) or croup (OR 0.16; 95% CI 0.01 to 4.06). No major adverse effects attributable to antibiotics were reported.
Comment: The quality of evidence is downgraded by study limitations (lack of allocation concealment and blinding) and by indirectness (the diagnosis of measles was made on a clinical basis; some very old trials included).
Primary/Secondary Keywords