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 cli
|Contact: Ekaterina Pesheva|
Johns Hopkins Medical Institutions