Benefits and risks Antibiotic treatment for non-severe pneumonia with wheeze
6.2 Antibiotic treatment for non-severe pneumonia with no wheeze
a Children with non-severe pneumonia i.e. fast breathing with no chest indrawing or danger sign should be treated with oral amoxicillin. he exception is in patients with HIV. — With low HIV prevalence, give amoxicillin of at least 40mgkgdose twice daily for 3 days. — With high HIV prevalence, give amoxicillin of at least 40mgkgdose twice daily for 5 days. Weak recommendation, moderate quality evidence b Children with non-severe pneumonia who fail on the irst line treatment with amoxicillin should have the option of referral where there is no appropriate second line treatment. Weak recommendation, expert opinion his recommendation was made based on mostly RCTs that were conducted in Asia, and more likely in low HIV prevalence settings. Amoxicillin was recommended based on values and preferences since dispersible amoxicillin is becoming more available and the cost is decreasing. he panel also clariied that the moderate quality evidence relates to comparisons of the duration of the two antibiotic regimens of amoxicillin for 3 versus 5 days which showed that they were no diferent in terms of cure and clinical failure rates.6.2.1 Evidence and summary of findings
Randomized trials have not shown signiicant diferences in the efectiveness of diferent oral antibiotics for the treatment of non-severe pneumonia in children see GRADE table A7.9 . Amoxicillin and co-trimoxazole are the most widely available antibiotics. Amoxicillin has been shown to be more efective than co-trimoxazole for treating severe pneumonia in one trial. here is no signiicant diference between short duration 3 day and long duration 5 day antibiotic therapy for non-severe pneumonia in low HIV prevalence settings. A systematic review [Sajwani, 2010] identiied trials comparing diferent oral antibiotics and short-course 3 days versus long-course 5 days oral antibiotics. Choice of antibiotic hree studies compared oral co-trimoxazole with oral amoxicillin. he studies involved 3952 children 2067 in the co-trimoxazole group and 1885 in the amoxicillin group between 2 months and 59 months of age with WHO-deined non-severe pneumonia. One study [Strauss, 1998] also included a subset of children with severe pneumonia. Two studies were double blinded RCTs, with adequate allocation concealment. he third study was an open-label and cluster-randomized. Primary outcomes were clinical cure and failure. Comparing amoxicillin to co-trimoxazole, pooled analysis shows no diference in clinical failure RR 1.09, 95 CI 0.93 to 1.27; 3 studies nor cure rate RR 0.99, 95 CI 0.96 to 1.01; 2 studies.Parts
» 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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