Amoxicillin has no benefit in treating bronchitis in children

A first-of-its-kind study has found that pediatricians should not prescribe antibiotics to treat uncomplicated respiratory tract infections in children for “just in case” reasons. The findings are published in The Lancet.

Amoxicillin (amoxiclav) is a semi-synthetic antibacterial drug from the penicillin group that is used to treat bronchitis, sore throat, pneumonia, otitis media, and other conditions in both adults and children. The antibiotic is on the World Health Organization’s list of essential medicines and is widely used in clinical practice.

Scientists from the University of Southampton decided to assess how justified it is to prescribe amoxicillin for uncomplicated respiratory tract infections in children in cases where there is no suspicion of pneumonia. In their scientific work, the experts emphasized that antibiotic resistance is becoming a global problem and it is very important to avoid their overuse.

The new study included 432 children aged 6 months to 12 years from England and Wales who were receiving outpatient treatment for upper respiratory tract infections with moderately severe symptoms. The young patients were randomly divided into two groups, one in which the children received amoxicillin three times a day for seven days and the other received a placebo. Doctors and nurses assessed symptoms at the start of therapy, and parents filled out a daily diary to monitor the child’s condition.

As a result, the researchers found that children in both groups recovered in about the same time frame – the difference averaged 13%, meaning it was clinically insignificant. Moreover, there were no significant differences in the duration of symptoms in children with the most severe symptoms – fever, shortness of breath and wheezing in the chest.

Five children taking amoxicillin and four patients in the control group required hospitalization. Other less significant measures such as the length of parental sick leave for child care and the cost of over-the-counter medications needed for treatment did not differ between the two groups.

There was also no evidence of additional complications in the absence of antibiotic prescribing. In the absence of suspected pneumonia, clinicians should explain to parents what course of illness to expect and when a follow-up visit will be needed, but not prescribe antibiotics for most children with respiratory infections.