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Short-Course Antibiotics Noninferior for Pediatric Pneumonia

WEDNESDAY, March 10, 2021 -- Five days of antibiotic therapy is noninferior to standard care for treatment of children with community-acquired pneumonia (CAP), according to a study published online March 8 in JAMA Pediatrics.

Jeffrey M. Pernica, M.D., from McMaster University in Hamilton, Ontario, Canada, and colleagues conducted a noninferiority trial involving 281 children aged 6 months to 10 years with CAP who received five days of high-dose amoxicillin therapy followed by five days of placebo (intervention) or five days of high-dose amoxicillin followed by five days of a different formulation of high-dose amoxicillin (control group).

The researchers found that 88.6 percent of children in the intervention group and 90.8 percent in the control group had clinical cure in the per-protocol analysis (risk difference, −0.016; 97.5 percent confidence limit, −0.087). At 14 to 21 days, clinical cure was observed in 85.7 and 84.1 percent of the intervention and control groups, respectively, in the intention-to-treat analysis (risk difference, 0.023; 97.5 percent confidence limit, −0.061).

"Several studies have proven that adults with pneumonia do fine with short courses of antibiotics, and now we have proved a short course of antibiotics also works for children," Pernica said in a statement. "The dramatic increase in antimicrobial resistance in the world today is driven by overuse of antibiotics -- which has only worsened during the COVID-19 pandemic. This is why we need these clinical studies -- to figure out how short we can make antibiotic treatment courses for common infections."

Two authors disclosed financial ties to the pharmaceutical industry.

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