Managing severe pneumonia in children in developing countries

doi:10.1136/bmj.39426.672118.80

BMJ 2008;336:57-58 (12 January), doi:10.1136/bmj.39426.672118.80 (published 8 January 2008)

Editorials

Managing severe pneumonia in children in developing countries

Increasing resistance to first line antibiotics means recommendationsneed changing

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

Despite advances in our understanding of the epidemiology anddistribution of deaths from pneumonia,¹ more than 150 millioncases of pneumonia still occur annually, with almost 2.4 milliondeaths worldwide. Pneumonia is perhaps the most frequent causeof death in children under 5, including during the newborn period.²Deaths from pneumonia in children have increased in the wakeof the HIV epidemic in Africa. Most deaths occur early in thecourse of illness. Because severe pneumonia is usually relatedto bacterial infection, treatment has largely focused on variousantibiotic strategies.

In the accompanying randomised controlled trial, Asghar andcolleagues compare the effectiveness of injectable ampicillinplus gentamicin or chloramphenicol in children aged 2-59 monthswith severe pneumonia (defined by World Health Organizationcriteria).³ The trial took place in inpatient wards in tertiarycare hospitals in Bangladesh, Ecuador, India, Mexico, Pakistan,Yemen, and Zambia. Significantly more children failed treatmentwith chloramphenicol . . . [Full text of this article]

Zulfiqar A Bhutta, Husein Lalji Dewraj professor and chairman

¹ Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan

zulfiqar.bhutta@aku.edu