Guidelines for Pediatric Pneumonia

Posted by: admin on: April 24, 2012

If prevention of pneumonia with flu shots fail, the first choice in treating babies and preschool kids is the age old drug Ampicillin says a recent study.


After one hospital set guidelines for how to treat children with pneumonia, the number getting the right antibiotic shot up, a new study finds.

According to guidelines from the Infectious Disease Society of America (IDSA), most children hospitalised with bacterial pneumonia should get an older, penicillin-like antibiotic called ampicillin — rather than newer, more powerful antibiotics that kill off a broad spectrum of bacteria.

Hospitals set own guidelines

In 2008, the hospital set its own guidelines saying that children with “uncomplicated” bacterial pneumonia should get ampicillin.

In the year before the guideline, just 13% of kids hospitalised with bacterial pneumonia were given ampicillin. That jumped to 63% in the year after the guideline took effect.

In contrast, during the pre-guideline year, 72% of kids received ceftriaxone (Rocephin), a newer “broad-spectrum” antibiotic.

Broad-spectrum antibiotics kill off a range of bacteria. The problem, Newland explained, is that overusing an antibiotic like ceftriaxone can lead to antibiotic resistance – which means the drug becomes ineffective against at least some of the bugs it’s intended to kill.

Ampicillin, in contrast, is a narrow-spectrum drug that fights the most common cause of bacterial pneumonia in kids – Streptococcus pneumonia.

Yearly flu shots
And Newland’s team found that the switch to ampicillin did not seem to do any harm.

In the pre-guideline year, 1.5% of 530 children had a treatment “failure” – meaning the pneumonia got worse and required more drugs or an invasive treatment. That rate was one percent in the year after the guideline took hold.

But this study helps confirm that ampicillin is safe and effective for kids’ pneumonia, Newland’s team says.

“And it gives credence to the new national (IDSA) guidelines,” Newland said.

But guidelines like the IDSA’s are aimed at getting more patients the antibiotics that are most effective, safest and least likely to feed the larger problem of antibiotic resistance.

“We are trying to standardize these things to improve the quality of care,” Newland said.

For parents, he noted, the findings are a reminder that newer and more powerful does not always mean better.

“Some people ask for newer antibiotics,” Newland said. “There’s a feeling that bigger is better. But these antibiotics (like ampicillin) are good because they’re narrower in focus.”

Parents can also help protect their kids from developing pneumonia in the first place, the IDSA stresses. Kids, like adults, often develop bacterial pneumonia after a viral infection, including the flu.

So it’s important, the IDSA says, for children ages six months and older to have a yearly flu shot, and to be up-to-date with all the recommended vaccinations.


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