Antibiotics are often prescribed for young children who have upper respiratory tract infections (URIs) in order to prevent complications, such as ear infections and pneumonia, however, a new evidence review in The Cochrane Library found no evidence to support this practice.
Lead author Márcia G. Alves Galvão, Ph.D., of the Municipal Secretariat of Health in Rio de Janeiro, Brazil, and her team explained that children's immature immune systems leave them vulnerable to many infections. URIs, which are mostly caused by viruses and typically run their course in 2-14 days, usually manifest themselves as coughs, but may also be accompanied by infections of the ears, sinuses or lungs, especially in low-income countries.
URIs are the most common reason that parents take young children to the doctor and lead to massive direct costs, high indirect costs including work absenteeism among parents, and even mortality, especially in disadvantaged groups, say the authors.
In high-income countries, the authors noted, these pediatric illnesses "are responsible for 75 percent of the total amount of prescribed antibiotics." Physicians prescribe antibiotics in hopes of preventing bacterial complications despite growing concerns about the drugs' misuse and mounting problems with resistance.
The authors reviewed four studies involving 1,314 children up to five years of age. The studies addressed the use of antibiotics to prevent two types of bacterial complications of URIs, ear infections (3 studies) and pneumonia (1 study). Although serious bacterial complications of URIs are rare, they are sometimes dangerous or fatal, and again such complications are more common in low income countries, the authors noted.
