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Antibiotic courses can be cut for pneumonia

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A short course of antibiotics is as effective as longer-term treatment for young children with non-severe pneumonia, a Cochrane review has found.

The current recommended duration of antibiotic treatment for children under five ranges from seven to 14 days but researchers say there is no evidence to support this treatment duration.

They carried out a systematic review of three clinical trials, involving 5,763 children younger than five, which compared three days of antibiotics with five days.

The researchers found no significant differences in the rates of cure, treatment failure or relapse between the different durations. They concluded that three days of treatment was equally as effective as five days.

Lead author Zulfiqar Bhutta, professor of paediatrics and child health at the Aga Khan University in Pakistan, said: ‘This short duration treatment is cheaper to give, is more likely to be taken by the child and is less likely to trigger antimicrobial resistance than longer duration regimens.’

In a separate study, Cochrane researchers found that treating patients for simple sinusitis with antibiotics was only marginally more effective than giving a placebo.

Their review of six studies – which allocated 747 patients to antibiotics or a placebo – found that, while 90% of the patients taking antibiotics improved within two weeks, 80% of those given placebos also improved over the same period.

Lead author Anneli Ahovuo-Saloranta, a research officer at the Finnish Office for Health Technology Assessment, said: ‘Clinicians need to weigh the small benefits of antibiotic treatment against the potential for adverse effects for both individuals and the general population.’

The Department of Health launched a campaign this year to remind healthcare professionals about the problem of antibiotic resistance (NT Clinical, 12 February, p23).

Details of the studies can be found at the Cochrane Library www.thecochranelibrary.com

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