Choosing between Antibiotics for Acute Respiratory Tract Infections in Children


Acute respiratory tract infections are the
really most, the most common things that kids present with, ear infections, strep throat,
and sinus infections, and then when we think about antibiotics they’re not all created
equal and this is a bit of a generalization but we tend to categorize them as either narrow
spectrum or broad spectrum and that has to do with the types of bacteria that they kill
and so that’s really what the comparison was about. Benefits and risks are really the center of
this this study and that’s what we really wanted to evaluate so when we think about
the benefits the benefits really are well does this treat the patient’s infection, and
we got really you know down and very granular with the benefits and we incorporated not
just what our perspective of benefits would be but the patient perspective so when we
think as clinicians we think of benefits, we think of how quickly do we cure the infection
and that’s important or how often do we cure the infection? When we talk to the families and the parents
and the children they also considered things that we you know eventually realized were
important but didn’t think about initially such as how often does this take you away
from work? How often does it make your child miss school? How what about sleep disturbance? Both primarily in the child but when a child’s
sleep is disturbed so is the entire family or at least one of the parents. So those were the benefits that we wanted
to look at: how well did these different types of antibiotics prevent some of these some
of these adverse things from happening whether it’s you know a continued infection or disruption
of family life or a child life. Our study found that when you compared broad-spectrum antibiotics to narrow spectrum antibiotics the broad-spectrum antibiotics didn’t offer
any clinical benefit in terms of treating the infection and in terms of the patient-centered
outcomes like disruption of sleep, work, day care, however the broad-spectrum antibiotics
ended up having a 40% relative increase in adverse effects including things like diarrhea,
rash, vomiting, and allergic reactions so the two drugs broad or narrow will treat your
infections equally but the broad-spectrum agents were more associated with more side
effects.

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