Should children use antibiotics for fever, sputum expectoration and shortness of breath?

Lower respiratory tract infections are more common in children, but other symptoms such as fever, cough, or difficulty breathing may be non-specific

Recently, a study (named ARTIC PC) funded by the National Institutes of Health (NIHR) and led by a research team at the University of Southampton explored whether antibiotics are effective for children with uncomplicated lower respiratory tract infections

The researchers recruited 432 children aged 6 months to 12 years with acute uncomplicated chest infection (pneumonia is not clinically suspected and the duration of symptoms is less than 21 days)

The doctor or prescribing nurse evaluates the symptoms at the beginning of the study, and the parents help the child complete a daily symptom diary

It was found that there was only a slight difference in the median duration of moderately severe or more severe symptoms reported between the two groups: children who took placebo had symptoms lasting about 6 days on average, while children who took antibiotics lasted 5 days.

In the five pre-designated clinical subgroups (for example, doctors heard sounds with a stethoscope, fever, sputum production, chest tightness, or shortness of breath), there were no differences in the main results between the treatment groups

The corresponding author of the study, Professor Paul Little of the University of Southampton, explained: “When the doctor believes that the child does not have pneumonia, giving the child amoxicillin to treat the chest infection will not make the child recover better.

The author of the study and Professor Alastair Hay of the University of Bristol's pointed out: “This trial is one of the few effectiveness studies

The "Lancet" in the same review article pointed out: "Children have symptoms such as fever, cough, or difficulty breathing, which is not enough to determine the cause of lower respiratory tract infection.

Reference

[1] Little, P.

[2] Largest trial of antibiotic amoxicillin for treating chest infections in children finds little effect.