Delayed antibiotics reduce adverse GI effects in kids with respiratory infections: Study
Spain: Children with uncomplicated respiratory tract infections (RTIs) who received delayed antibiotic prescription (DAP) had reduced gastrointestinal adverse effects and less antibiotic use versus those who received immediate antibiotic prescription (IAP), finds recent study. The study is published in the AAP journal Pediatrics.
However, there was no significant difference in symptom severity or duration in children who received DAP compared to no antibiotic prescription (NAP) or IAP strategies.
Gemma Mas-Dalmau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain, and colleagues aimed to assess safety and effectiveness of DAP compared to IAP and NAP in children with uncomplicated respiratory infections.
For the purpose, the researchers performed a randomized clinical trial that compared 3 antibiotic prescription strategies. It included 436 children with acute uncomplicated respiratory infections attended to in 39 primary care centers.
Children were randomly assigned into three prescription arms -- DAP, IAP, or NAP. Primary outcomes were symptom duration and severity. Secondary outcomes were antibiotic use, parental satisfaction, parental beliefs, additional primary care visits, and complications at 30 days.
Key findings of the study include:
- The mean (SD) duration of severe symptoms was 10.1 for IAP, 10.9 for NAP, and 12.4 for DAP, although the differences were not statistically significant.
- The median (interquartile range) of the greatest severity for any symptom was similar for the 3 arms.
- Antibiotic use was significantly higher for IAP (n = 142 [96%]) compared to DAP (n = 37 [25.3%]) and NAP (n = 17 [12.0%]).
- Complications, additional visits to primary care, and satisfaction were similar for all strategies.
- Gastrointestinal adverse effects were higher for IAP.
"There was no statistically significant difference in symptom duration or severity in children with uncomplicated respiratory infections who received DAP compared to NAP or IAP strategies; however, DAP reduced antibiotic use and gastrointestinal adverse effects," concluded the authors.
The study titled, "Delayed Antibiotic Prescription for Children With Respiratory Infections: A Randomized Trial," is published in the journal Pediatrics.
DOI: https://pediatrics.aappublications.org/content/early/2021/02/09/peds.2020-1323
