John Libbey Eurotext

Journal de Pharmacie Clinique

MENU

A narrative review of short versus long-course antibiotic treatment for community-acquired pneumonia in the outpatient pediatric setting Volume 41, issue 2, Juin 2022

Figures

  • Figure 1.

Tables

Authors
1 B.Pharm M.Sc, MBA Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
2 M.Sc, PhD, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
3 M.Sc(A), Pharm.D, Leslie Dan Faculty of Pharmacy, Toronto, Ontario, Canada
Correspondance : J. Cameron

Background

Clinical practices regarding duration of antibiotics used for Community Acquired Pneumonia (CAP) in children vary between settings. This could contribute to adverse drug reactions, treatment failure and antimicrobial resistance.

Methods

The following search tools were used for the review: PubMed, TRIP, and Medline/Ovid. Keywords included were “pneumonia”, “pediatric”, “treatment”, “duration”, “child”, “days”, “community acquired pneumonia”, “short”, “non-severe”, “amoxicillin dose”, and “pneumonia children” and the selection of articles was limited to the last 10 years from 2011 to 2021.

Results

We found 15 studies that assessed short (3 or 5 days) versus longer (7 or 10 days) duration of antibiotic treatment in pediatric outpatient CAP. Of these we selected 8 studies: 5 completed Randomized Controlled Trials (RCTs), 2 ongoing RCTs, and 1 retrospective cohort study.

Discussion

Our review shows that short-course antimicrobial therapy for outpatient pediatric CAP is a promising option for maximizing efficacy, while also minimizing adverse effects, non-adherence, and antimicrobial resistance. Half of RCTs showed that a short-course treatment with oral amoxicillin, the antibiotic of reference, had a comparable efficacy to longer course treatment. However, in these studies bacterial CAP was not easily established, and there was considerable variability in the diagnosis and interpretation of radiological findings.

Conclusion

The results from the studies included in this narrative review are informative and add to our understanding of outpatient pediatric CAP. They highlight the importance of maintaining an effective balance, where a clinician can aim to minimize antimicrobial overuse and risk of resistance while maximizing efficacy. Although these studies look promising, future research is required in pediatric patients with CAP, and these studies must be capable of addressing the limitations listed in this paper.