Children With Pneumonia Don’t Routinely Need Antibiotics

When children have pneumonia, giving them an antibiotic may be no more helpful than giving them none.

Antibiotics are effective only for bacterial pneumonia, not viral, and it is often difficult to tell the difference. So doctors often prescribe an antibiotic for children just in case. A new study suggests that it might be better to skip it.

Researchers studied 294 children, aged 3 months to 18 years, who had pneumonia that had been diagnosed by chest X-ray or clinical impression. Half were given prescriptions for antibiotics, and half were discharged from the emergency room without a prescription. The groups were matched for many characteristics, including age, sex and severity of illness. The study is in Pediatrics.

Of the 294 children, 8.8 percent failed treatment — that is, they had to return to the hospital for admission or have a change in antibiotics. But there was no statistical difference in treatment failure between the children who got antibiotics at discharge and those who did not.

Nor was there any difference between the two groups in other symptoms, as reported by the parents — diarrhea, vomiting, stomach pain or the time it took them to get better.

Consistent with current clinical guidelines, “children with pneumonia should not routinely be treated with antibiotics,” said the lead author, Dr. Matthew J. Lipshaw, a pediatric emergency physician at Cincinnati Children’s Hospital. “But we also know that those guidelines are not consistently followed.”