Severe Pneumonia in Children can be Safely Treated at Home

Children with severe pneumonia can be treated with oral antibiotics as safely and effective at home as in a hospital, according to a new report.

Researchers at the Boston University School of Public Health (MA, USA) looked at 2,037 children aged from three months to just under six years at seven sites in Pakistan, in an attempt to find out whether the treatment for severe pneumonia at home with oral antibiotics was as safe and effective as parenteral treatment given in the hospital. Half the children were randomly selected to receive oral amoxicillin syrup and sent back home, while the other half were hospitalized and received intravenous ampicillin for forty-eight hours.

The results showed that by the sixth day there were 77 (7.5%) treatment failures among the children who stayed at home, compared to 87 (8.6%) among the hospitalized children. Within 14 days of enrolment, five children died, four of them from the hospitalized group. In each case, treatment failure was declared before death and the antibiotic was changed. No serious adverse events were reported in the trial, and none of the deaths were thought to be linked to treatment. The study was published in the January 5, 2008, issue of The Lancet.

"Because the agents that cause pneumonia in Pakistani children do not differ from those in most other developing countries, our findings have important public-health policy and programmatic implications, particularly for integrated management of childhood illness [IMCI] guidelines,” said lead author Dr. Donald Thea, M.D. "Ambulatory management of severe pneumonia in children has the potential to improve access to care and inequity while reducing costs and mortality from pneumonia.”

Approximately four children under five years of age die as a result of pneumonia every minute--two million per year worldwide. The authors claim that current IMCI guidelines issued by the World Health Organization (WHO; Geneva, Switzerland) for severe pneumonia treatment in children are ineffective. The investigators stressed that community-based treatment options would significantly boost the number of children who would receive treatment, many deaths would be prevented, money would be saved, and there would be a reduction in the potential hazards of in-hospital treatment.


Related Links:
Boston University School of Public Health
World Health Organization