Short-course antibiotic for paediatric CAP on par with long-course regimen

A short-course antibiotic treatment for children with community-acquired pneumonia (CAP) demonstrates effectiveness similar to the long-course regimen but with fewer serious adverse events (AEs), reports a study.

A team of investigators searched the databases of PubMed, Embase, Cochrane Library, and KoreaMed for studies comparing the efficacy and safety of short-course with long-course antibiotic regimens in children with CAP. They assessed the risk of bias using the RoB 2 and ROBINS-I tools and recorded study characteristics, such as publication year, country, setting, design, and antibiotic regimens.

Seventeen studies involving a total of 155,944 children met the eligibility criteria. Of these, 15 were randomized controlled trials.

No significant differences were observed between short-course and long-course treatment in terms of clinical cure (21,156 patients; risk ratio [RR], 1.01, 95 percent confidence interval [CI], 0.97–1.05; p=0.73; I², 81 percent), treatment failure (28,942 patients; RR, 0.88, 95 percent CI, 0.51–1.51; p=0.64; I², 94 percent), or total AEs (24,446 children; RR, 0.94, 95 percent CI, 0.61–1.44; p=0.77; I², 90 percent).

However, short-course antibiotic therapy resulted in fewer serious AEs (4,194 patients, RR, 0.89, 95 percent CI, 0.79–0.99; p=0.04; I², 11 percent) and nominally lower relapse rates compared with long-course treatments (5.5 percent vs 6.2 percent; p=0.04). This difference was seen in the subgroup analysis comparing 5- to ≥10-day treatments.

On the other hand, hospitalization rates did not significantly differ between the two regimens (122,607 patients; RR, 1.20, 95 percent CI, 0.851.68; p=0.29; I², 0 percent).

“Short-course antibiotic treatment is as effective as long-course treatment for paediatric CAP in terms of clinical cure and treatment failure while resulting in fewer serious AEs,” the investigators said.