Oral Antibiotic Effective for Childhood Pneumonia

Pneumonia is one of the world's deadliest diseases for young children in developing countries. Now, a new study shows pneumonia could be treated with the oral antibiotic amoxicillin rather than injectable penicillin to produce better health outcomes and reduce treatment costs.

The World Health Organization has recommended penicillin given by injection as the treatment for severe pneumonia. Yet, if oral amoxicillin proves equally effective, it could reduce referral, admission and treatment costs.

The study included 1,700 children between the ages of 2 months and 5 years old from developing countries in Africa, Asia and South America. The children were randomly treated with injectable penicillin or oral amoxicillin. The outcome, as measured by treatment failure after 48 hours, was the same in both groups (19 percent). The treatment outcomes were also the same between the two groups at the five-day and 14-day follow-ups.

The study authors say if their findings were applied to public health policy, oral amoxicillin would reduce needle-borne infections, the need for referral and admission to medical care, treatment costs, and transport, food and lost income costs for the family.

In an accompanying editorial, Keith P. Klugman, from Emory University in Atlanta, agrees with many of the benefits shown in this study. However, he says the evidence is less clear for the suggestion that oral amoxicillin could reduce the need for hospitalization of children with severe pneumonia.

Klugman says, "All the children enrolled in this study were initially admitted to the hospital. Therefore, they also received the probable benefits of medical attention, nutritional support, and supplemental oxygen therapy." He concludes this study warrants further study on the efficacy of oral antibiotics for these children, but along with improved access to nutritional support and oxygen.


SOURCE: The Lancet, 2004;364:1141-1148