Navigation Links
Short antibiotic courses safer for breathing-tube infections in children
Date:5/5/2011

Short courses of antibiotics appear just as effective as longer ones - and a great deal safer - in treating respiratory infections that might cause pneumonia in children on temporary breathing devices, according to a Johns Hopkins Children's Center study published online May 3 in Clinical Infectious Diseases.

In the study's analysis of 150 children treated with antibiotics for respiratory infections while on a ventilator, longer antibiotic courses did not only fail to confer extra protection against full-blown pneumonia when compared with shorter therapy, but also considerably increased a child's risk for developing drug-resistant infections within a month.

To rein in the spread of bacterial drug resistance, the researchers advise clinicians to carefully evaluate the need for antibiotics in the first place and to use antibiotics for the shortest time needed to achieve clinical effect.

"Our study underscores the old physician maxim to first do no harm," said lead investigator Pranita Tamma, M. D., an infectious disease specialist at the Johns Hopkins Children's Center. "Longer treatment is not always more effective, and it could be downright dangerous."

Children on ventilators often develop respiratory infections, or tracheitis, because the breathing tubes allow bacteria an easy entry into the respiratory tract. These children need antibiotics promptly to prevent the infection from spreading into the lungs, but the optimal length of treatment has been unclear.

"We hope that our findings will help clear up some of the confusion and discourage physicians from preemptively opting for longer treatments," Tamma said.

The Johns Hopkins investigators analyzed three years of medical records involving more than 1,600 children, age 18 and younger, who spent at least two days on a breathing tube. Of them, 150 got antibiotics for ventilator-related upper respiratory infections; only 118 of them, however, met clinical criteria for such infections, and 32 were treated merely on suspicion of infection.

Of the 82 children with actual infections who were treated with antibiotics for more than a week, 23 percent developed pneumonia, compared to 20 percent of the 36 children who got antibiotics for seven days or fewer. Children who received the lengthy antibiotic course were, however, five times more likely, on average, to develop drug-resistant infections following the treatment. Children who got multiple antibiotics were three times as likely to do so.

Although the length of antibiotic use made no statistical difference in pneumonia risk, the length of intubation did. Children whose tubes were left in after diagnosis of infection and start of therapy were four times more likely to progress to pneumonia than children taken off the ventilator promptly after diagnosis and start of treatment, the researchers found. The finding emphasizes the need for careful daily reassessment of each child's need to stay on a ventilator, they added.

Past research has shown that more than one-third of antibiotic prescriptions for upper respiratory infections in the intensive care unit may be unwarranted, the investigators noted.

"Beyond fueling drug resistance, antibiotics can cause serious side effects and add to healthcare costs. We, as physicians, should ask ourselves two critical questions any time we prescribe them: 'Does this patient really need antibiotics?' If so, 'what is the shortest course of treatment that will achieve clinical benefit?'" said senior investigator Sara Cosgrove, M.D., an infectious disease specialist at Johns Hopkins.


'/>"/>

Contact: Ekaterina Pesheva
epeshev1@jhmi.edu
410-926-6780
Johns Hopkins Medical Institutions
Source:Eurekalert

Related medicine news :

1. American Council on Exercise (ACE) Study Reveals Kettlebells Provide Powerful Workout in Short Amount of Time
2. For Some Breast Cancer Patients, Shorter Radiation Works Well
3. Short-term radiation therapy successful on breast cancer
4. No End In Sight To The Armour Thyroid Shortage?
5. WHI data confirm short-term heart disease risks of combination menopausal hormone therapy
6. Americans Falling Short on Heart-Healthy Fruits and Vegetables
7. Website for Nursing Jobs Launches -- Streamlined Job Board Created to Address Nursing Shortage
8. Los Angeles Jewish Home Adds Short-Term Rehabilitative Care to Family of Services
9. Newer cornea transplant surgery shows short- and long-term promise
10. Short on specialized intensive care physicians, team-based approach improves ICU outcomes
11. Apex Heart Care, First Arizona Clinic to Install Shape-HF; New Medical Device Measures Patient Physiology to Define Shortness of Breath
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/24/2016)... ... June 24, 2016 , ... June 19, 2016 is World Sickle ... chronic pain and the benefits of holistic treatments, Serenity Recovery Center of ... Sickle Cell Disease. , Sickle Cell Disease (SCD) is a disorder of the red ...
(Date:6/24/2016)... ... June 24, 2016 , ... The Pulmonary ... Dallas that it will receive two significant new grants to support its work ... marked its 25th anniversary by recognizing patients, medical professionals and scientists for their ...
(Date:6/24/2016)... ... June 24, 2016 , ... ... for accelerated orthodontic treatment. Dr. Cheng has extensive experience with all areas of ... AcceleDent, and accelerated osteogenic orthodontics. , Micro-osteoperforation is a revolutionary adjunct to ...
(Date:6/24/2016)... ... ... Topical BioMedics, Inc, makers of Topricin and MyPainAway Pain Relief Products, join The ‘Business for ... $12 an hour by 2020 and then adjusting it yearly to increase at the same ... wage, assure the wage floor does not erode again, and make future increases more predictable. ...
(Date:6/24/2016)... , ... June 24, 2016 , ... ... at the Clinical Decision Making in Emergency Medicine conference in Ponte Vedra Beach, ... journal articles published in Emergency Medicine Practice and Pediatric Emergency Medicine ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... , Belgium , June 24, ... VNRX), today announced the appointment of Dr. ... Directors as a Non-Executive Director, effective June 23, ... Audit, Compensation and Nominations and Governance Committees.  As ... Futcher will provide independent expertise and strategic counsel ...
(Date:6/23/2016)... June 23, 2016 Any dentist who has made ... the current process. Many of them do not even offer ... difficulties and high laboratory costs involved. And those who ARE ... at such a high cost that the majority of today,s ... Dr. Parsa Zadeh , founder of Dental Evolutions Inc. ...
(Date:6/23/2016)... -- Research and Markets has announced the addition ... - Forecast to 2022" report to their offering. ... to date financial data derived from varied research sources to ... potential impact on the market during the next five years, ... of sub markets, regional and country level analysis. The report ...
Breaking Medicine Technology: