Benefits and risks Prevention of hypothermia immediately after birth in low birth
6. Evidence for recommendations for treatment of pneumonia
6.1 Antibiotic treatment for non-severe pneumonia with wheeze
Antibiotics are not routinely recommended for children with non-severe pneumonia i.e. fast breathing with no chest indrawing or danger sign with a wheeze but with no fever temperature 38 °C, as the cause is most likely to be viral. Strong recommendation, low quality evidence his recommendation is applicable only in situations where the health workers are able to assess “wheeze”. he panel observed that there is evidence that WHO criteria for diagnosing pneumonia performs poorly in children with wheeze; that the addition of fever to WHO criteria improves diagnostic accuracy in this group of children; and that children with wheeze and no fever are very unlikely to have bacterial pneumonia.6.1.1 Evidence and summary of findings
No systematic reviews addressing the efectiveness of antibiotics in children with non-severe pneumonia were identiied. However, two recent RCTs provide direct evidence. he evidence for the efectiveness of antibiotics is mixed, in part due to the signiicant but as yet undetermined proportion of children fulilling the criteria for non-severe pneumonia, who have either a viral illness or non-infectious aetiology. In Asia, up to 60 of children with non-severe pneumonia are reported to also have an audible wheeze by auscultation. Observational data provides evidence that: the addition of fever to the WHO cri- teria for pneumonia improves its speciicity for children with wheeze, and children with non-severe pneumonia and wheeze, with no fever or history of fever, have a low risk of bacterial pneumonia and most recover without antibiotics. here is also new evidence from one trial in Pakistan showing that antibiotics are no better than place- bo for children with WHO-deined non-severe pneumonia see GRADE table A7.8 . Antibiotics in all children presenting with non-severe pneumonia in Pakistan Hazir et al 2010 conducted a double-blinded, randomized, placebo-controlled trial of oral amoxicillin versus placebo for non-severe pneumonia in four centres in Pakistan. Children were enrolled if they fulilled WHO criteria for non-severe pneumonia: cough or diiculty breathing and fast breathing using age-dependant WHO cut-ofs. he study recruited 900 children, and randomized 450 childrenParts
» Hospital Care WHO evidence 0
» Objectives of the recommendations
» Management of conflict of interest
» Defining the scope Methodology and process
» Evidence retrieval and synthesis process
» Consensus building and external peer review
» Review and update of the recommendations
» Proposed subsidiary products Implementation of the recommendations
» Implementation of the recommendations
» National adaptation and implementation
» Management of neonatal jaundice Empirical antibiotics for suspected neonatal sepsis
» Antibiotic treatment for non-severe pneumonia with no wheeze
» Inhaled salbutamol for treatment of acute wheezeasthma and
» Antibiotics for treatment of acute otitis media
» Clinical signs for detection of hypoxaemia in children
» Oxygen delivery methods Criteria for starting and stopping oxygen therapy
» Evidence and summary of findings
» Benefits and risks Acceptability and feasibility
» Evidence and summary of findings Benefits and risks
» Acceptability and feasibility Management of neonatal jaundice
» Benefits and risks Head or whole body cooling in management of hypoxic ischaemic
» Acceptability and feasibility Head or whole body cooling in management of hypoxic ischaemic
» Evidence and summary of recommendations
» Acceptability and feasibility Kangaroo Mother Care
» Benefits and risks Prevention of hypothermia immediately after birth in low birth
» Acceptability and feasibility Prevention of hypothermia immediately after birth in low birth
» Benefits and risks Antibiotic treatment for non-severe pneumonia with wheeze
» Acceptability and feasibility Antibiotic treatment for non-severe pneumonia with wheeze
» Benefits and risks Antibiotic treatment for non-severe pneumonia with no wheeze
» Acceptability and feasibility Antibiotic treatment for non-severe pneumonia with no wheeze
» Benefits and risks Antibiotics treatment for severe pneumonia
» Acceptability and feasibility Antibiotics treatment for severe pneumonia
» Evidence and summary of findings Benefits and risks Acceptability and feasibility
» Acceptability and feasibility Salbutamol for treatment of acute wheezeasthma and
» Acceptability and feasibility Antibiotics for treatment of acute bacterial meningitis
» Benefits and risks Antibiotic treatment for Acute Otitis Media AOM
» Acceptability and feasibility Antibiotic treatment for Chronic Suppurative Otitis Media CSOM
» Benefits and risks Topical steroids for treatment of Chronic Suppurative Otitis Media
» Acceptability and feasibility Topical steroids for treatment of Chronic Suppurative Otitis Media
» Benefits and risks Antibiotic treatment for Typhoid Fever
» Acceptability and feasibility: Antibiotic treatment for Typhoid Fever
» Benefits and risks Antibiotics use in the management of severe acute malnutrition
» Acceptability and feasibility Antibiotics use in the management of severe acute malnutrition
» Acceptability and feasibility: Oxygen therapy in treatment of hypoxaemia
» Acceptability and feasibility Oxygen therapy delivery methods
» Benefits and risks Criteria for starting and stopping oxygen therapy
» Acceptability and feasibility Criteria for starting and stopping oxygen therapy
» Benefits and risks Sublingual administration of sugar in treatment of hypoglycaemia
» Acceptability and feasibility Sublingual administration of sugar in treatment of hypoglycaemia
» Benefits and risks Choice of intravenous fluids for resuscitation and maintenance in
» Vitamin K prophylaxis in newborns
» Skin-to-skin contact in the first hour of life
» Management of neonatal jaundice
» Kangaroo Mother Care Outline of the research gaps
» Prevention of hypothermia immediately after birth in VLBW infants
» Management of children with non-severe pneumonia and wheeze
» Antibiotics for severe pneumonia
» Antibiotics for very severe pneumonia
» Treatment of non-severe pneumonia
» Problems of the neonate and young infant
» Fever Severe malnutrition Hospital Care WHO evidence 0
» Children with HIVAIDS Hospital Care WHO evidence 0
» Common surgical conditions Hospital Care WHO evidence 0
» Supportive care Hospital Care WHO evidence 0
» Monitoring the child’s progress
» Counselling and discharge from hospital
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