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Antibiotics for community acquired lower respiratory tract infections (LRTI) secondary to Mycoplasma pneumoniae in children (Review)

Gavranich, John B. and Chang, Anne B. (2005). Antibiotics for community acquired lower respiratory tract infections (LRTI) secondary to Mycoplasma pneumoniae in children (Review). Cochrane Database of Systematic Reviews,2005(3 - Articel No. CD004875).

Document type: Journal Article
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Title Antibiotics for community acquired lower respiratory tract infections (LRTI) secondary to Mycoplasma pneumoniae in children (Review)
Author Gavranich, John B.
Chang, Anne B.
Journal Name Cochrane Database of Systematic Reviews
Publication Date 2005
Volume Number 2005
Issue Number 3 - Articel No. CD004875
ISSN 1469-493X   (check CDU catalogue open catalogue search in new window)
Total Pages 22
Place of Publication United Kingdom
Publisher John Wiley and Sons Ltd.
HERDC Category C1 - Journal Article (DEST)
Abstract Background
Mycoplasma pneumoniae (M. pneumoniae) is widely recognised as an important cause of community-acquired lower respiratory tract infection (LRTI) in children. Pulmonary manifestations are typically tracheobronchitis or pneumonia but M. pneumoniae is also implicated in wheezing episodes in both asthmatic and non-asthmatic individuals. Although antibiotics are used to treat LRTI, a review of several major textbooks offers conflicting advice for the use of antibiotics in the management of M. pneumoniae LRTI in children.

Objectives
To determine whether antibiotics are effective in the treatment of childhood LRTI secondary to M. pneumoniae infections acquired in the community.

Search strategy
We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2005, issue 1), which contains the Acute Respiratory Infection Group's Specialized Register; MEDLINE (1966 to February 2005); and EMBASE (1980 to December 2004).

Selection criteria
Randomised controlled trials comparing antibiotics commonly used for treating M. pneumoniae (i.e. macrolide, tetracycline or quinolone classes) versus placebo, or antibiotics from any other class in the treatment of children under 18 years of age with community acquired LRTI secondary to M. pneumoniae.

Data collection and analysis
The authors independently selected trials for inclusion and assessed methodological quality. Relevant data were extracted and analysed separately and any disagreements were resolved by consensus.

Main results
A total of 1352 children were enrolled from six studies. The number of children from one study was unavailable. Data interpretation was significantly limited by the inability to extract data that specifically referred to children with M. pneumoniae. Clinical response did not differ between the children randomised to a macrolide antibiotic and the children randomised to a non-macrolide antibiotic. There were no studies comparing relevant antibiotics with placebo.

Authors' conclusions
This review found insufficient evidence to draw any conclusions about the efficacy of antibiotics for LRTI secondary to M. pneumoniae in children. The use of antibiotics for M. pneumoniae LRTI has to be individualised and balanced with possible adverse events associated with antibiotic use. There is a need for high quality, double-blinded randomised controlled trials to assess the efficacy and safety of antibiotics for LRTI secondary to M. pneumoniae in children.
Keywords Antibiotics
children
community
infections
Mycoplasma pneumoniae
respiratory tract
DOI http://dx.doi.org/10.1002/14651858.CD004875.pub2   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)


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