A Comprehensive Analysis of the Effectiveness of Antibiotic Regimens for Pneumonia in Young Infants Ages 0–59 Days

Pneumonia is one of the prominent causes of mortality in young infants, resulting in >200 000 deaths each year. Children of all ages can have pneumonia, but young infants (ages 0–59 days) bear the brunt of the disease in terms of years of life lost, and their case fatality rate is significantly greater than that of older children. It is believed that early and effective treatment with supportive care, supplemental oxygen, and the right medications can prevent the majority of pneumonia-related deaths in infants.

The current study was conducted to assess the effectiveness of different antibiotic regimens to treat young infant pneumonia on critical clinical outcomes. Researchers reviewed data from multiple databases and included randomized controlled trials involving infants aged 0 to 59 days.

The study revealed the following findings:

• Out of 2601 publications, 10 trials were included, with 7 hospital-based and 3 nonhospital-based. 
• None of the hospital-based trials investigated WHO-recommended first-choice regimens.
• According to one study, the treatment success rates of cefotaxime, the second-choice antibiotic recommended by the WHO, were comparable to those of amoxicillin–clavulanate (RR 0.99, 95% CI 0.82–1.10) or amoxicillin–clavulanate/cefotaxime (RR 1.02, 95% CI 0.86–1.12), which were not recommended by the WHO. 
• There were no differences in treatment failure between oral amoxicillin and other regimens in three nonhospital-based trials that compared them for treating isolated tachypnea in infants aged 7–59 days.
• For every primary outcome, the level of evidentiary certainty was low or extremely low.

Thus, it can be concluded that the study found limited evidence to support the superiority of one antibiotic regimen over others for treating young infant pneumonia.

Source: North K, Frade Garcia A, Crouch M, Kimsen S, Hoey A, Wade C, Kim Y, Chou R, Edmond KM, Lee ACC, Rees CA. Efficacy of Antibiotic Regimens for Pneumonia in Young Infants Aged 0-59 Days: A Systematic Review. Pediatrics. 2024 Aug 1;154(Suppl 1):e2024066588G. doi: 10.1542/peds.2024-066588G. PMID: 39087803; PMCID: PMC11460314.