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Study outlines new treatment regimen for children with chest-indrawing pneumonia

A new study outlines a better way to treat chest-indrawing pneumonia in children that shortens treatment time, decreases the chance of antimicrobial resistance, and simplifies treatment options for healthcare providers. The study was published July 1 in the New England Journal of Medicine.

“Even before the advent of the COVID-19 respiratory pandemic, pneumonia was the leading infectious killer globally, taking the lives of over 800,000 children each year,” says the study’s first author Amy Ginsburg, principal investigator of the Innovative Treatments in Pneumonia project and a clinical research scientist with the University of Washington Clinical Trial Center housed within the Department of Biostatistics in the School of Public Health.

Healthcare site in Malawai
Health clinic in Malawi. Photo courtesy Village Reach

The study enrolled 3,000 children in Lilongwe, Malawi, a setting selected because sparse African-specific research exists about managing children with chest-indrawing pneumonia in areas where malaria is prevalent. The research found that three-day treatment with amoxicillin for chest-indrawing pneumonia was as effective as the five-day regimen currently recommended by the World Health Organization (WHO).

This reduction in treatment duration provides a number of benefits. It has the potential to bring chest-indrawing pneumonia treatment in line with the current WHO recommended three-day regimen for fast-breathing pneumonia (both pneumonias are considered non-severe by the WHO, although, chest-indrawing pneumonia is considered more severe).

This not only simplifies treatment delivery for health care providers but improves the chance that a treatment regimen will be completed. Poor adherence to antibiotics has been associated with treatment failure, according to the study authors.

More importantly, decreasing treatment time could minimize the emergence of antimicrobial resistance.

“In this age of global viral respiratory pandemics, antimicrobial drug resistant superbugs, and persistently high pneumonia mortality worldwide, using antibiotics thoughtfully is critical to preserving their effectiveness, and as COVID-19 rages on, addressing the deadly bacterial superinfections,” says Ginsburg.

Looking forward Ginsburg notes, “This is just one trial, but one could imagine that the WHO and others would consider further study and potentially changing the guidelines.”

Other School of Public Health researchers involved with the study include Professor of Biostatistics Susanne May, senior author of the paper, and research scientists Robert Schmicker and Jun Hwang, who are co-authors.

Deb Nelson, Biostatistics communications and event manager