Whether treated with narrow- or broad-spectrum therapy, clinical outcomes and costs are the same children hospitalized with community-acquired pneumonia (CAP), according to the results of a Vanderbilt study published in Pediatrics.
“Sometimes there is a perception, not restricted to pneumonia, that the use of a broad spectrum antibiotic, a big gun, is going to be the best treatment for all patients. This perception can complicate the selection of antibiotics especially when there is limited information to support the decision,” said senior author Carlos G. Grijalva, MD, MPH, assistant professor of Health Policy.
“To help inform those decisions, this study compared two pneumonia treatment regimens, a big gun (broad spectrum antibiotics) vs. a small gun (narrow spectrum antibiotics), and found there were no significant differences in clinical outcomes or associated costs.”
Investigators compared data from 43 children’s hospitals across the U.S., looking at outcomes among children 6 months to 18 years of age hospitalized for pneumonia who were treated with either ampicillin or penicillin (narrow spectrum) or a third-generation cephalosporin (ceftriaxone or cefotaxime,[broad spectrum]). According to the PIDS/IDSA guidelines, both treatment strategies are effective for disease caused by Streptococcus pneumoniae, the most common bacterial cause of pneumonia.
“We have seen increases in use of broad spectrum antibiotics and concurrent increases in disease caused by resistant bacteria. For this study, we hypothesized that narrow and broad-spectrum antibiotics would have similar effectiveness in the treatment of childhood pneumonia,” said lead author Derek J. Williams, MD, MPH, assistant professor of Pediatrics. “Our findings support the preferential use of narrow spectrum antibiotics as first-line therapies for most children hospitalized with pneumonia.”