Antibiotics for preventing complications from acute respiratory infections in children

Antibiotics appear not to reduce the risk of otitis or pneumonia in children up to 5 years of age with undifferentiated acute respiratory infections.

The quality of evidence is downgraded by study limitations (unclear allocation concealment and lack of blinding).

Summary

A Cochrane review 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.

Clinical comments

Date of latest search:

Ədəbiyyat

1. Alves Galvão MG, Rocha Crispino Santos MA, Alves da Cunha AJ. Antibiotics for preventing suppurative complications from undifferentiated acute respiratory infections in children under five years of age. Cochrane Database Syst Rev 2016;(2):CD007880.