Amoxicillin Alone May Be As Effective As Combo Therapy at Treating Pneumonia in Children

The results of a new study from Vanderbilt University Medical Center show that prescribing 1 antibiotic to treat community-acquired pneumonia in children may be as effective as the usual 2-antibiotic treatment, in most cases.

For the study, published in JAMA Pediatrics, a team of investigators, led by Derek Williams, MD, MPH, assistant professor of Pediatrics at Vanderbilt, studied a total of 1418 children (693 girls and 725 boys) who had been hospitalized for community-acquired pneumonia, confirmed radiologically. A total of 72% of the children received amoxicillin, while 28% received amoxicillin plus azithromycin.

The investigators found that “there were no significant differences in length of stay, intensive care admission, readmissions or recovery at follow-up between the groups,” according to a press release on the study, concluding that there was no benefit in prescribing the combination therapy over the single drug therapy of amoxicillin.

Interesting, the investigators also found, “no differences among important subgroups of children most likely to benefit from the combination therapy, including children with Mycoplasma pneumoniae, those with wheezing, and those admitted to intensive care,” according to the press release.

The results of this study are important in that they can aid in supporting efforts to combat antibiotic resistance. The use of 1 antibiotic instead of the combination of 2 minimizes exposure to antibiotics, which in turn helps to preserve their effectiveness, according to Dr. Williams. An accompanying editorial on the study cited data indicating azithromycin is the most commonly prescribed antibiotic in pediatrics, accounting for “almost 20% of all antibiotic prescriptions for children in the US ambulatory setting.”

“Pneumonia accounts for more antibiotic days in US children's hospitals than any other condition,” Dr. Williams added in the press release. “It is a hugely important target for antimicrobial stewardship efforts. Reducing unnecessary antibiotic use in pediatric pneumonia and other respiratory illnesses is one strategy to help slow the progression of antimicrobial resistance.”

This study is one part of a larger study on pneumonia in children and adults taking place at Vanderbilt Medical Center, as well as other sites in Utah, Chicago, and Memphis.