Lassi Zohra S, Imdad Aamer, Bhutta Zulfiqar A
The Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia, 5005.
Cochrane Database Syst Rev. 2017 Oct 11;10(10):CD008032. doi: 10.1002/14651858.CD008032.pub3.
Pneumonia is a leading cause of childhood mortality from infectious disease, responsible for an estimated 1.3 million deaths annually in children under five years of age, many of which are in low-income countries. The World Health Organization recommends intravenous antibiotics for five days as first-line treatment for children with severe pneumonia. Although controversy exists regarding the specific clinical features used to diagnose pneumonia, the criteria for diagnosis of severe pneumonia are better defined and are widely used to triage children for referral and second-line therapy.In 2011 it was estimated that approximately 120 million new cases of pneumonia occur globally each year in children under five years of age, of which 14 million become severe episodes. Hospitalisation for severe pneumonia in children places a significant burden on both patients and their families, including substantial expense, loss of routine, and decrease in quality of life. By reducing the duration of hospital treatment, healthcare burdens could potentially be reduced and treatment compliance may improve.This is an update of a review published in 2015.
To evaluate the efficacy of short-course (two to three days) versus long-course (five days) intravenous therapy (alone or in combination with oral antibiotics) with the same antibiotic for severe community-acquired pneumonia in children aged two months to 59 months.
We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 12), MEDLINE (1966 to December week 3, 2016), Embase (1974 to 22 December 2016), and four trials registers (23 August 2017), together with reference checking of all relevant trials and reviews.
Randomised controlled trials evaluating the efficacy of short-course (two to three days) versus long-course (five days) intravenous antibiotic therapy (alone or in combination with oral antibiotics) for severe pneumonia in children aged two months to 59 months. We excluded children with any other debilitating disease, including those infected with HIV. We also excluded children who had developed pneumonia during their hospital stay (i.e. with nosocomial infection). There was no restriction on the type of antibiotic used, the dose, or the frequency of dosing.
We used standard methodological procedures expected by Cochrane.
Our searches identified 4295 records, however no studies met our predefined inclusion criteria.
AUTHORS' CONCLUSIONS: We identified no randomised controlled trials comparing a short course (two to three days) of intravenous antibiotics compared to a long course (five days) for severe pneumonia in children aged two months to 59 months that met our inclusion criteria.
肺炎是儿童感染性疾病死亡的主要原因，据估计，每年五岁以下儿童中有130万死于肺炎，其中许多发生在低收入国家。世界卫生组织建议，对于患有严重肺炎的儿童，静脉注射抗生素五天作为一线治疗方法。尽管在用于诊断肺炎的具体临床特征方面存在争议，但严重肺炎的诊断标准定义得更好，并被广泛用于对儿童进行分诊以进行转诊和二线治疗。2011年估计，全球每年五岁以下儿童中约有1.2亿例新发肺炎病例，其中1400万例病情加重。儿童因严重肺炎住院给患者及其家庭带来了沉重负担，包括巨额费用、日常生活中断和生活质量下降。通过缩短住院治疗时间，医疗负担可能会减轻，治疗依从性可能会提高。这是对2015年发表的一篇综述的更新。
评估短疗程（两到三天）与长疗程（五天）静脉治疗（单独或联合口服抗生素）使用相同抗生素治疗2个月至59个月儿童严重社区获得性肺炎的疗效。
我们检索了Cochrane对照试验中心注册库（CENTRAL；2016年第12期）、MEDLINE（1966年至2016年12月第3周）、Embase（1974年至2016年12月22日）以及四个试验注册库（2017年8月23日），并对所有相关试验和综述进行了参考文献核对。
随机对照试验，评估短疗程（两到三天）与长疗程（五天）静脉抗生素治疗（单独或联合口服抗生素）对2个月至59个月儿童严重肺炎的疗效。我们排除了患有任何其他衰弱性疾病的儿童，包括感染艾滋病毒的儿童。我们还排除了在住院期间发生肺炎的儿童（即医院感染）。对抗生素的类型、剂量或给药频率没有限制。
我们采用了Cochrane预期的标准方法程序。
我们的检索共识别出4295条记录，但没有研究符合我们预先设定的纳入标准。
我们未发现符合我们纳入标准的比较2个月至59个月儿童严重肺炎短疗程（两到三天）静脉抗生素与长疗程（五天）静脉抗生素的随机对照试验。
