Narrow Target Antibiotics Are Better For Kids With Respiratory Infections

The doctors must adopt a selective approach while prescribing antibiotics for kids who suffer from common respiratory infections. A research was carried out by the researchers on 30,000 patients. They studied the treatment practices in patients with strep throat, earaches and other infections. The researchers found out that the narrow-spectrum antibiotics had fewer side-effects as compared to the broad-spectrum antibiotics.

The narrow-spectrum antibiotics were as potent or better as compared to the broad-spectrum antibiotics.

The research showed an "antimicrobial stewardship" approach indicting towards the need of prescribing appropriate antibiotics targeting a specific type of infection to improve the individual outcome and cut off the susceptibility of antibiotic resistance.

Jeffrey Gerber, PhD, MD, the study leader states that many kids unnecessarily take broad-spectrum antibiotics for the treatment of common infections which causes unnecessary adverse-effects and develops antibiotic resistance in children. Taking inappropriate antibiotics also cause too many practical issues like missing school and work, adverse-effects of the medicines and extra childcare expenditure.

The study was published on Dec. 19, 2017 in the Journal of the American Medical Association by Gerber and colleagues. The study was funded by an award from the Patient-Centered Outcomes Research Institute (PCORI).

The team also carried out two complimentary studies in thirty one primary care practices in Children's Hospital of Philadelphia's pediatric network in New Jersey as well as Pennsylvania, between January 2015 and April 2016. They checked the electronic health records of infants and kids up to 12 years of age, who were diagnosed with ARTI (acute respiratory tract infection). They prescribed them antibiotics. In 30,000 patients, 14% took broad-spectrum antibiotics and 86% took narrow-spectrum antibiotics.

The acute respiratory tract infections that were analysed included earache (otitis media), strep throat (Group A streptococcal pharyngitis and sinus infection (sinusitis). The researchers studied the clinical results in a retrospective cohort of 30,000 kids along with studying the prospective cohort of 2,472 kids. They did telephonic interviews with the caregivers to evaluate the highest concerning issues like adverse-effects of the drugs, lingering symptoms, additional childcare expenditure as well as missed school days.

The team found out that the adverse-effects were higher with broad-spectrum antibiotics as compared to the narrow-spectrum antibiotics (3.7% vs. 2.7% as registered by clinicians and 35.6% vs. 25.1%, as told by patients and families). The rates of the failure of treatment were almost the same with broad- and narrow-spectrum antibiotics.

CHOP's CPCE (Center for Pediatric Clinical Effectiveness) has released a research brief and a policy tip sheet. According to Gerber, the research states that the antibiotic stewardship programs reduce the risk of antibiotic resistance and improve patient outcomes. They also lower the expenditure for insurers as well as families who have to pay for the medicine bills and other related things. The programs are the best for public health, insurers as well as for the families.