Not going to the hospital might be best course, study finds
FRIDAY, Jan. 4 (HealthDay News) -- In developing countries, treating children with pneumonia at home is as safe and effective as hospital care, a new study finds.
Worldwide, pneumonia kills 2 million children under the age of 5 each year. However, antibiotics given at home could significantly reduce deaths, the researchers report.
"Severe in pneumonia in children can be safely and successfully treated at home versus the current standard of care, which is hospitalization," said lead researcher Dr. Donald Thea, a professor of international health at Boston University School of Public Health. "Pneumonia is the biggest killer of children in the world."
Thea's team studied 2,037 children aged 3 to 59 months at seven sites in Pakistan. About half the children received amoxicillin syrup and were sent home, and the others received intravenous antibiotics in the hospital, according to the report in the Jan. 5 issue of The Lancet.
Among the children treated in the hospital, 87 didn't respond to the antibiotic, compared with 77 who were treated at home. Five children died within two weeks; one was treated at home and four were treated in the hospital.
Based on these findings, Thea hopes the World Health Organization (WHO) will change its guidelines for the treatment of pneumonia, which currently call for hospitalization.
In developing countries, many children with severe pneumonia never get to hospitals due to poor transportation, cost, distance and lack of child care at home, Thea said. This makes the current guidelines ineffective. Home-based care could increase the number of children receiving effective care, prevent deaths, decrease the potential hazards of hospital treatment, such as infection, and reduce costs, he noted.
Thea noted that these findings really have no implications for treating pneumonia in developed countries. "Extending these findings to the United States or other developed countries is problematic," he said.
The ultimate goal of this effort is to train local health workers in developing countries to diagnose and treat pneumonia in the community, Thea said. "Hopefully, this will make major inroads and mitigate some of the deaths," he added.
One expert agreed that this method of treating children with pneumonia could reduce deaths.
"This is a very important study," said Dr. William Schaffner, vice president of the National Foundation for Infectious Diseases and chairman of the Department of Preventive Medicine at Vanderbilt University School of Medicine. "In the developing world, one needs an efficient way to manage children with pneumonia."
"The results of this study are going to have strong implications for what WHO recommends to the ministries of health and to health-care providers in how to approach pneumonia in children in the developing world," Schaffner said. "It will reduce deaths from pneumonia."
For more information on pneumonia, visit the U.S. National Institute of Allergy and Infectious Diseases.
SOURCES: Donald Thea, M.D., professor, international health, Boston University School of Public Health; William Schaffner, M.D., vice president, National Foundation for Infectious Diseases, and chairman, Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville; Jan. 5, 2008, The Lancet
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