BMJ  2004;328:1566-1567 (26 June), doi:10.1136/bmj.328.7455.1566-b

Letter

Amoxicillin for non-severe pneumonia in young children

Stop skimping, start investing in antibiotic treatment

The first 150 words of the full text of this article appear below.

EDITOR—The limitations of the paper on three v five days of antibiotic treatment for pneumonia merit additional emphasis.1 The paper had an inadequate selection of indicators of treatment failure, an insufficiently discriminating treatment comparison (also pointed out by Borja and Rigau (next letter)), insufficient detailing of patients' history, dismissiveness towards caregivers' assessments, deficient survivor data, and difficulties in applying the conclusion of the study to broader populations.

If the conclusion was acted on, predictable deaths might occur, particularly in undiagnosed asthma. Roughly 54 000 people die in Britain each year from complications related to respiratory infections.

Skimping on antibiotics is a contested tactic. False economy is evident when patients are admitted to hospital and intubated for infections that could have been managed less invasively with appropriate antibiotics.

Skimping does not address the need for a new generation of antibiotics. No one seriously doubts that antibiotics are at times . . . [Full text of this article]

Lynne Wrennall, fellow

University of Liverpool, Liverpool L69 3BX lynnew@liverpool.ac.uk


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Relevant Article

Three day versus five day treatment with amoxicillin for non-severe pneumonia in young children: a multicentre randomised controlled trial
BMJ 2004 328: 791. [Abstract] [Full Text] [PDF]

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