Broad-Spectrum Antibiotics Linked To Increased Risks For Children With Respiratory Tract Infections

Prescribing broad-spectrum antibiotics for children with respiratory tract infections does not appear to provide any benefit or improve their outcomes, yet may increase their risk of experiencing side effects, according to the findings of new research. 

In a study published this week in the Journal of the American Medical Association (JAMA), researchers found that, when compared to narrow-spectrum antibiotics, broad spectrum antibiotics did not offer patients with respiratory tract infections any benefits. They also found that children who were given broad-spectrum antibiotics had lower quality of life and high rates of side effects.

Researchers with Children’s Hospital of Philadelphia studied more than 30,000 children with acute respiratory tract infections, including acute otitis media, group A streptococcal pharyngitis, and acute sinusitis. Children were treated between January 2016 and April 2016 at a network of 31 pediatric primary care practices in Pennsylvania and New Jersey. Children were ages 6 months to 12 years.

The broad-spectrum antibiotics given during the study included amoxicillin-clavulanate antibiotics, like amoxicillin or brand name Augmentin; cephalosporins, like Ceporex, Cefalexin and Duricef; as well as macrolides, like azithromycin or Zithromax, calrithromycin or Clacid, and erythromycin or Erythrocin.

The findings indicated treating children with acute respiratory tract infections with broad-spectrum antibiotics increased a child’s risk of side effects. Compared to children treated with narrow-spectrum antibiotics, the increased risk of side effects for broad-spectrum antibiotics was 4% compared to 3% for narrow-spectrum antibiotics.

Researchers also studied nearly 2,500 children for a second part of the study. They received either broad-spectrum antibiotics or narrow-spectrum antibiotics. Children who received broad-spectrum antibiotics had a 35% increased risk of decreased quality of life and side effects, compared to 25% among the children who were given narrow-spectrum antibiotics.

Overall, broad-spectrum antibiotics were not associated with better outcomes or patient-centered outcomes in children with respiratory tract infections, the researchers concluded.

The findings may be important, because acute respiratory tract infections account for the majority of antibiotic exposure in children, the researchers noted. Yet, broad spectrum antibiotic prescribing for acute respiratory tract infections is increasing.

Researchers concluded that the findings support the use of narrow-spectrum antibiotics for most children with acute respiratory tract infections, compared to use of broad-spectrum antibiotics.