Pneumonia—one of the world’s deadliest diseases for young children in developing countries—could be treatable by the oral antibiotic amoxicillin rather than injectable penicillin, with implications for better health outcomes and reduced costs, conclude authors of an international study in this week’s issue of THE LANCET.
Nearly 2 million children under 5 years of age die every year in developing countries from respiratory diseases such as pneumonia. Penicillin given by injection is the recommended treatment for severe pneumonia defined by the World Health Organisation (lower chest indrawing). It is proposed that oral amoxicillin could reduce referral, admission, and treatment costs if it can be proven to be as effective as injectable penicillin.
In a randomised trial done in eight developing countries in Africa, Asia, and South America, around 1700 children aged between 3 months and 5 years admitted to tertiary care centres were randomly allocated to receive either injectable penicillin or oral amoxicillin. The main outcome measure of the study—treatment failure after 48 hours— was the same in both groups (19%). There was also no difference in outcome between the two groups at 5-day and 14-day follow-up.
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