Oral antibiotics versus parenteral antibiotics for severe pneumonia in children

Peroral antibiotics may be as effective as parenteral antibiotics in children with severe pneumonia diagnosed by the WHO criteria.

A Cochrane review included 2 studies with a total of 1836 subjects who had severe pneumonia according to WHO criteria. The diagnosis was not confirmed by chest radiographs. The studies were performed in Africa and in South America. In the first study, treatment failure occurred in 6/66 (9.1%) in children receiving oral co-trimoxazole and 7/68 (10.2%) in those receiving intramuscular procaine penicillin followed by oral ampicillin. In the second study (n=1702) treatment failure after 48 hours occurred in 161/845 (19%) in children receiving amoxicillin and 167/857 (19%) in those receiving parenteral penicillin. The authors reported similar recovery in both groups at 5 and 14 days.

Comment: The quality of evidence is downgraded by indirectness (different antibiotics were compared) and by limitations in study quality.

Ədəbiyyat

1. Rojas MX, Granados C. Oral antibiotics versus parenteral antibiotics for severe pneumonia in children. Cochrane Database Syst Rev 2006 Apr 19;(2):CD004979.