PURPOSE OF REVIEW: Most childhood respiratory infections including acute otitis media (AOM), sore throat, upper respiratory tract infections (URTIs) and sinusitis are self-limiting illnesses. Yet, despite extensive guidance discouraging routine use of antibiotics to limit side-effects and combat antimicrobial resistance, antibiotic prescribing for these conditions remains high in many developed countries, fuelled by the fear of rare but serious bacterial complications including mastoiditis, quinsy, pneumonia and brain abscess. This review summarizes evidence for the role of antibiotics in preventing serious complications of URTIs in children. RECENT FINDINGS: From a key observational study reporting antibiotic use in children, the calculated excess risk of suppurative complications of respiratory tract infections in children who did not receive an antibiotic was 3.8 per 10 000. Despite extensive searches of the literature, no data were found to assess the affect of antibiotics upon the risk of brain abscess after sinusitis in children. SUMMARY: New information from observational studies suggests antibiotics show little benefit in preventing complications of mastoiditis following AOM, quinsy following sore throat and pneumonia following URTI/bronchitis. Further research should focus on stratifying the key risk factors for such complications and optimizing long-term monitoring strategies to detect any future changes in the risk-benefit analysis for antibiotic prescription.
PURPOSE OF REVIEW: Most childhood respiratory infections including acute otitis media (AOM), sore throat, upper respiratory tract infections (URTIs) and sinusitis are self-limiting illnesses. Yet, despite extensive guidance discouraging routine use of antibiotics to limit side-effects and combat antimicrobial resistance, antibiotic prescribing for these conditions remains high in many developed countries, fuelled by the fear of rare but serious bacterial complications including mastoiditis, quinsy, pneumonia and brain abscess. This review summarizes evidence for the role of antibiotics in preventing serious complications of URTIs in children. RECENT FINDINGS: From a key observational study reporting antibiotic use in children, the calculated excess risk of suppurative complications of respiratory tract infections in children who did not receive an antibiotic was 3.8 per 10 000. Despite extensive searches of the literature, no data were found to assess the affect of antibiotics upon the risk of brain abscess after sinusitis in children. SUMMARY: New information from observational studies suggests antibiotics show little benefit in preventing complications of mastoiditis following AOM, quinsy following sore throat and pneumonia following URTI/bronchitis. Further research should focus on stratifying the key risk factors for such complications and optimizing long-term monitoring strategies to detect any future changes in the risk-benefit analysis for antibiotic prescription.
Authors: Alan C Kinlaw; Til Stürmer; Jennifer L Lund; Lars Pedersen; Michael D Kappelman; Julie L Daniels; Trine Frøslev; Christina D Mack; Henrik Toft Sørensen Journal: Pediatrics Date: 2017-08-14 Impact factor: 7.124
Authors: Talley A Vodicka; Matthew Thompson; Patricia Lucas; Carl Heneghan; Peter S Blair; David I Buckley; Niamh Redmond; Alastair D Hay Journal: Br J Gen Pract Date: 2013-07 Impact factor: 5.386
Authors: Sotiria G Panagakou; Nuikos Spyridis; Vassiliki Papaevangelou; Kalliopi M Theodoridou; Georgia P Goutziana; Maria N Theodoridou; George A Syrogiannopoulos; Christos S Hadjichristodoulou Journal: BMC Pediatr Date: 2011-07-05 Impact factor: 2.125
Authors: Thomas Cars; Irene Eriksson; Anna Granath; Björn Wettermark; Jenny Hellman; Christer Norman; Anders Ternhag Journal: BMJ Open Date: 2017-11-15 Impact factor: 2.692