Pneumonia (sometimes called chest infection) is a fairly common illness, especially for small children. It is commonly treated with the antibiotic drug amoxicillin and usually ends without complications.
However, doctors haven’t been completely sure about the duration of antibiotic treatment and what dose should be used. A new CAP-IT trial led by UCL researchers found answers to those questions.
Amoxicillin is the most popular antibiotic used to treat pneumonia in children. Image credit: Sage Ross via Wikimedia (CC BY-SA 3.0)
In this trial scientists recruited 824 children, aged six months and over and weighing 6-24 kg, in 29 hospitals in the UK and Ireland. All participants of the study were treated with amoxicillin, but some received a higher dose, some – lower, some were treated for a shorter period of time and some – for longer. This randomized trial was designed to figure out the most optimal treatment approach to reach the best possible results in childhood pneumonia.
This trial showed that the shorter course of treatment was no less effective than the longer course. Also, the lower dose was also sufficient. This is actually great news, because excessive use of any kind of antibiotics contributes to antibiotic resistance. The low dose of amoxicillin was 35-50 mg/kg and the shorter duration of the treatment took only three days. In other words, the dosage of the antibiotics could be reduced from 15-21 doses over 5-7 days, which is the current guidelines, to six doses over three days.
Dr Julia Bielicki, joint first author of the study, said: “The CAP-IT study provides family-friendly evidence that shorter durations of amoxicillin given twice daily are safe and effective even in young children with serious chest infections attending hospital. It has also demonstrated again that large strategic trials that inform the optimal choice of drug, dose and duration of antibiotics to treat common infections are feasible and critical to tackling antibiotic resistance.”
Scientists also stress that updated guidelines based on this trial would be easier to follow for families and parents could be sure that their children are treated safely and effectively while receiving a lower dose of the drug. And, of course, scientists can use the same methodology to optimize the treatment with other drugs as well, which could have a whole range of benefits for everyone.
Antibiotic resistance is quite a big issue at the moment. With time the effectiveness of our current antibiotics is going to decline significantly as bacteria is evolving to avoid being killed by current medicine. The current solution is to increase the dose or use stronger antibiotics, which causes a whole lot of adverse side effects. But it is best to avoid giving bacteria the opportunity to evolve that resistance and limit the use of antibiotics.
Source: UCL