Evidence map›Paper›PMID 36823052›Full record

Trial reportThe British journal of general practice : the journal of the Royal College of General Practitioners2023

Antibiotic effectiveness for children with lower respiratory infections: prospective cohort and trial in primary care.

Paul Little, Taeko Becque, Alastair D Hay, Nick A Francis, Beth Stuart, Gilly O'Reilly, Natalie Thompson, Kerenza Hood, Michael Moore, Theo Verheij

Open access · hybridAbstract readRandomized Controlled TrialObservational Study
In one paragraph

Trial report in The British journal of general practice : the journal of the Royal College of General Practitioners, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.1field-weighted citation impact, top 49% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Antibiotic stewardship: where next?The British journal of general practice : the journal of the Royal College of General Practitioners · 2023
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 2 countries.

Paul LittlePrimary Care Population Sciences and Medical Education Unit, University of Southampton, Southampton, UK.ORCID 0000-0003-3664-1873
Taeko BecquePrimary Care Population Sciences and Medical Education Unit, University of Southampton, Southampton, UK.ORCID 0000-0002-0362-3794
Alastair D HayCentre for Academic Primary Care, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK.ORCID 0000-0003-3012-375X
Nick A FrancisPrimary Care Population Sciences and Medical Education Unit, University of Southampton, Southampton, UK.ORCID 0000-0001-8939-7312
Beth StuartPrimary Care Population Sciences and Medical Education Unit, University of Southampton, Southampton, UK.ORCID 0000-0001-5432-7437
Gilly O'ReillyPrimary Care Population Sciences and Medical Education Unit, University of Southampton, Southampton, UK.ORCID 0000-0001-6141-4360
Natalie ThompsonPrimary Care Population Sciences and Medical Education Unit, University of Southampton, Southampton, UK.ORCID 0000-0002-1880-6438
Kerenza HoodCentre for Trials Research, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK.ORCID 0000-0002-5268-8631
Michael MoorePrimary Care Population Sciences and Medical Education Unit, University of Southampton, Southampton, UK.ORCID 0000-0002-5127-4509
Theo VerheijJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands.ORCID 0000-0002-0166-1498
Southampton City Council · GBCardiff University · GBUniversity Medical Center Utrecht · NLUniversity of Bristol · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAntibiotics are commonly prescribed for children with chest infections but there is little randomised evidence and trials commonly recruit selected populations, which undermines their applicability.

aimTo document the effectiveness of antibiotics for chest infections in children. DESIGN AND

settingThis was a prospective cohort study with nested trial in primary care.

methodChildren aged 1-12 years presenting with uncomplicated lower respiratory tract infections were included in the cohort. Children were either randomised to receive amoxicillin 50 mg/kg per day for 7 days or placebo, or participated in a parallel observational study, where propensity scores controlled for confounding by indication. The outcomes were duration of symptoms rated moderately bad or worse (primary outcome) and illness progression requiring hospital assessment.

resultsA total of 764 children participated (438 trial, 326 observational), and children were more unwell than in previous cohorts (more sputum, fever, shortness of breath). Children had been unwell for a median of 5-6 days, and symptoms rated moderately bad or worse lasted another 6 days when no antibiotics were given.With antibiotics there was a non-significant reduction of approximately 1 day in duration of symptoms rated moderately bad or worse for the whole cohort (hazard ratio [HR] 1.16, 95% confidence interval [CI] = 0.95 to 1.41), similar to the trial alone (HR 1.13, 95% CI = 0.90 to 1.43). The effect of antibiotic treatment on secondary outcomes was also non-significant.

conclusionAntibiotics for uncomplicated chest infections, even in a sample of more unwell children, are unlikely to be clinically very effective.

Indexed as

Anti-Bacterial AgentsRespiratory Tract InfectionsAmoxicillinChildHumansPrimary Health CareProspective StudiesAmoxicillinAnti-Bacterial Agentsantibiotic resistanceantibioticschest infectionschildrenprimary care

Identifiers

PMID36823052
PMCPMC9762762
OpenAlexW4306693748

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.