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Treatment of Severe Community-Acquired Pneumonia with Oral Amoxicillin in Under-Five Children in Developing Country: A Systematic Review
OBJECTIVE: To assess the evidence regarding efficacy of oral amoxicillin compared to standard treatment for WHO-defined severe community acquired pneumonia in under-five children in developing country. DESIGN: Systematic review and meta-analysis of data from published Randomized trials (RCTs). DATA...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3692509/ https://www.ncbi.nlm.nih.gov/pubmed/23825532 http://dx.doi.org/10.1371/journal.pone.0066232 |
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author | Das, Rashmi Ranjan Singh, Meenu |
author_facet | Das, Rashmi Ranjan Singh, Meenu |
author_sort | Das, Rashmi Ranjan |
collection | PubMed |
description | OBJECTIVE: To assess the evidence regarding efficacy of oral amoxicillin compared to standard treatment for WHO-defined severe community acquired pneumonia in under-five children in developing country. DESIGN: Systematic review and meta-analysis of data from published Randomized trials (RCTs). DATA SOURCES: MEDLINE (1970– July 2012) via PubMed, Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 7, July 2012), and EMBASE (1988– June 2012). METHODS: Eligible trials compared oral amoxicillin administered in ambulatory setting versus standard treatment for WHO-defined severe community acquired pneumonia in children under-five. Primary outcomes were proportion of children developing treatment failure at 48 hr, and day 6. GRADE criteria was used to rate the quality of evidence. RESULTS: Out of 281 full text articles assessed for eligibility, 5 trials including 12364 children were included in the meta-analysis. Oral amoxicillin administered either in hospital or community setting is effective in treatment of severe pneumonia and is not inferior to the standard treatment. None of the clinical predictors of treatment failure by 48 hr (very severe disease, fever and lower chest indrawing, and voluntary with-drawl and loss to follow up) was significant between the two groups. The clinical predictors of treatment failure that were significant by day 6 were very severe disease, inability to drink, change of antibiotic, and fever alone. The effect was almost consistent across the studies. CONCLUSION: Though oral amoxicillin is effective in treatment of severe CAP in under-five children in developing country, the evidence generated is of low-quality. More trials with uniform comparators are needed in order to strengthen the evidence. |
format | Online Article Text |
id | pubmed-3692509 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-36925092013-07-02 Treatment of Severe Community-Acquired Pneumonia with Oral Amoxicillin in Under-Five Children in Developing Country: A Systematic Review Das, Rashmi Ranjan Singh, Meenu PLoS One Research Article OBJECTIVE: To assess the evidence regarding efficacy of oral amoxicillin compared to standard treatment for WHO-defined severe community acquired pneumonia in under-five children in developing country. DESIGN: Systematic review and meta-analysis of data from published Randomized trials (RCTs). DATA SOURCES: MEDLINE (1970– July 2012) via PubMed, Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 7, July 2012), and EMBASE (1988– June 2012). METHODS: Eligible trials compared oral amoxicillin administered in ambulatory setting versus standard treatment for WHO-defined severe community acquired pneumonia in children under-five. Primary outcomes were proportion of children developing treatment failure at 48 hr, and day 6. GRADE criteria was used to rate the quality of evidence. RESULTS: Out of 281 full text articles assessed for eligibility, 5 trials including 12364 children were included in the meta-analysis. Oral amoxicillin administered either in hospital or community setting is effective in treatment of severe pneumonia and is not inferior to the standard treatment. None of the clinical predictors of treatment failure by 48 hr (very severe disease, fever and lower chest indrawing, and voluntary with-drawl and loss to follow up) was significant between the two groups. The clinical predictors of treatment failure that were significant by day 6 were very severe disease, inability to drink, change of antibiotic, and fever alone. The effect was almost consistent across the studies. CONCLUSION: Though oral amoxicillin is effective in treatment of severe CAP in under-five children in developing country, the evidence generated is of low-quality. More trials with uniform comparators are needed in order to strengthen the evidence. Public Library of Science 2013-06-25 /pmc/articles/PMC3692509/ /pubmed/23825532 http://dx.doi.org/10.1371/journal.pone.0066232 Text en © 2013 Das, Singh http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Das, Rashmi Ranjan Singh, Meenu Treatment of Severe Community-Acquired Pneumonia with Oral Amoxicillin in Under-Five Children in Developing Country: A Systematic Review |
title | Treatment of Severe Community-Acquired Pneumonia with Oral Amoxicillin in Under-Five Children in Developing Country: A Systematic Review |
title_full | Treatment of Severe Community-Acquired Pneumonia with Oral Amoxicillin in Under-Five Children in Developing Country: A Systematic Review |
title_fullStr | Treatment of Severe Community-Acquired Pneumonia with Oral Amoxicillin in Under-Five Children in Developing Country: A Systematic Review |
title_full_unstemmed | Treatment of Severe Community-Acquired Pneumonia with Oral Amoxicillin in Under-Five Children in Developing Country: A Systematic Review |
title_short | Treatment of Severe Community-Acquired Pneumonia with Oral Amoxicillin in Under-Five Children in Developing Country: A Systematic Review |
title_sort | treatment of severe community-acquired pneumonia with oral amoxicillin in under-five children in developing country: a systematic review |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3692509/ https://www.ncbi.nlm.nih.gov/pubmed/23825532 http://dx.doi.org/10.1371/journal.pone.0066232 |
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