Acute Respiratory Tract Infections in Children: Broad- vs Narrow-Spectrum Antibiotics

HealthDay News — For children with acute respiratory tract infections, broad-spectrum antibiotics are not associated with better clinical or patient-centered outcomes compared with narrow-spectrum antibiotics, according to a study published in the Journal of the American Medical Association.

Jeffrey S. Gerber, MD, PhD, from the Children’s Hospital of Philadelphia in Pennsylvania, and colleagues compared the effectiveness of broad-spectrum and narrow-spectrum antibiotic treatment in a retrospective cohort study assessing clinical outcomes (30,159 children) and a prospective cohort study (2472 children). The studies assessed patient-centered outcomes for children aged 6 months to 12 years diagnosed with acute respiratory tract infection and prescribed an oral antibiotic.

The researchers found that 14% of the children in the retrospective cohort study were prescribed broad-spectrum antibiotics. The rate of treatment failure was not lower for broad-spectrum treatment (3.4% vs 3.1% for narrow-spectrum antibiotics; risk difference, 0.3% [95% CI, −0.4% to 0.9%]). In the prospective cohort, 35% of the children were prescribed broad-spectrum antibiotics, which correlated with slightly worse quality of life (score, 90.2 for broad-spectrum antibiotics vs 91.5 for narrow-spectrum antibiotics; score difference, −1.4% [95% CI, −2.4% to −0.4%); no correlation was seen with other patient-centered outcomes. An increased risk for adverse events documented by the clinician and reported by the patients was seen with broad-spectrum treatment.

“These data support the use of narrow-spectrum antibiotics for most children with acute respiratory tract infections,” the authors wrote.

Disclosures: Two authors disclosed financial ties to the biopharmaceutical industry.

Reference

Gerber JS, Ross RK, Bryan M, et al. Association of broad- vs narrow-spectrum antibiotics with treatment failure, adverse events, and quality of life in children with acute respiratory tract infections. JAMA. 2017;318(23):2325-2336.