Simpler Antibiotic Regimen Helps Sick Babies in Developing Nations

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Newborns and young infants in developing nations who have suspected severe bacterial infections can be effectively treated outside a hospital, two new studies suggest.

The findings indicate that the World Health Organization’s guidelines on treating newborns and young infants with possible bacterial infections — such as pneumonia and sepsis (blood infection) — should be altered, the researchers said.

About one in five babies worldwide develops severe bacterial infections during the first month of life, leading to about 700,000 deaths in newborns every year, the researchers explained. Current WHO guidelines recommend that newborns and young infants believed to have such infections be hospitalized and treated with antibiotic injections for at least seven to 10 days.

However, many parents in developing nations can’t afford, or don’t have access to, such hospital care. Some refuse to take their children to the hospital, or aren’t willing to adhere to the antibiotic injection program, the researchers said.

The new studies were published April 1 in The Lancet and The Lancet Global Health.

“Safe, effective, simplified treatment alternatives provided on an outpatient basis could help increase the number of children receiving care, improve adherence to treatment, and reduce the burden on limited hospital resources and the risk of hospital-acquired infections,” Ebunoluwa Adejuyigbe, co-lead author of one of the studies, said in a Lancet news release. Adejuyigbe is dean of the School of Medicine at Obafemi Awolowo University in Nigeria.

The studies included thousands of children, aged 0 to 59 days, in Africa and Bangladesh who had symptoms of possible severe bacterial infections such as pneumonia or sepsis, but whose parents could not, or did not want to, take them to the hospital.

In one African trial, the children received either the antibiotic amoxicillin in syrup form twice daily or standard antibiotic injections once a day for seven days. The antibiotic syrup was as effective as the injections, and adherence to the liquid antibiotic was better than adherence to the injections, the researchers found.

In another African trial, the children received either antibiotic injections or a simplified approach featuring fewer injections combined with oral antibiotics for seven days, with similar successful results. Again, both regimens were equally effective and there was better adherence to the simplified regimen.

The findings from those trials appear in The Lancet.

In the Bangladesh study, patients received either standard daily antibiotic injections or a reduced number of injections combined with liquid antibiotics for seven days. As in the other trials, the simplified regimen was as effective as the standard regimen, according to the findings published in The Lancet Global Health.

A child health specialist welcomed the findings.

“This could improve access to care for millions of families in Africa and substantially reduce costs and deaths from possible severe bacterial infections,” Fabian Esamai, professor of child health and pediatrics in the College of Health Sciences at Moi University in Kenya, said in the news release.

But for outpatient treatment to be effective, two other experts said frontline treatment centers need to be open on a regular basis and have adequate supplies.

“The interface between home and the treating health center, and between the treatment provider and the hospital doctor, will need to be optimized and supported,” said the authors of an accompanying editorial in The Lancet Global Health.

More information

The U.S. National Library of Medicine has more about bacterial infections.

Source: HealthDay

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