HealthDay News — For children with acute uncomplicated lower respiratory tract infection (LRTI) not suspected of being pneumonia, amoxicillin is unlikely to be clinically effective, according to a study published online September 22 in The Lancet.

Paul Little, MBBS, MD, from the University of Southampton in the United Kingdom, and colleagues randomly assigned eligible children aged 6 months to 12 years presenting in primary care with acute uncomplicated LRTI judged to be infective in origin with symptoms for less than 21 days, where pneumonia was not suspected clinically, to receive amoxicillin 50mg/kg/day or placebo for 7 days (221 and 211 patients, respectively).

The researchers found that the median durations of moderately bad or worse symptoms were similar between the groups (5 vs 6 days in the antibiotic group vs the placebo group; hazard ratio, 1.15; 95% CI, 0.90 to 1.42). In the 5 prespecified clinical subgroups (patients with chest signs, fever, physician rating of unwell, sputum or chest rattle, and shortness of breath), there were no differences observed for the primary outcome.

“Using amoxicillin to treat chest infections in children not suspected of having pneumonia is not likely to help and could be harmful,” Little said in a statement. “Overuse of antibiotics, which is dominated by prescribing of antibiotics in primary care, particularly when they are ineffective, can lead to side effects and the development of antibiotic resistance.”


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One author disclosed financial ties to the pharmaceutical industry.

Abstract/Full Text