Narrow-spectrum antibiotics favourable for paediatric respiratory infections, researchers say

Research has shown that broad-spectrum antibiotics are associated with slightly worse quality of life in children compared with narrow-spectrum antibiotics, without providing a significant benefit

Toddler with inhaler mask

Some guidelines recommend broad-spectrum antibiotics for certain respiratory infections in children. However, it is unclear whether this leads to improved outcomes over narrow-spectrum antibiotics.

In a paper in JAMA (19 December 2018), researchers analysed data on 30,159 children aged 6 months to 12 years who were prescribed an oral antibiotic for acute respiratory tract infection during a 15-month period[1]

They found that broad-spectrum antibiotics, such as amoxicillin-clavulanate, were not associated with a lower rate of treatment failure compared with narrow-spectrum antibiotics (3.4% vs 3.1%, respectively). However, they were associated with a slightly worse quality of life and higher rates of adverse events.

The researchers concluded that the results suggest broad-spectrum antibiotics are not associated with better clinical or patient-centred outcomes than narrow-spectrum antibiotics, and that narrow-spectrum antibiotics should be prescribed for most children with acute respiratory infections.


[1] Gerber J, Ross R, Bryan M et al. Association of broad- vs narrow-spectrum antibiotics with treatment failure, adverse events, and quality of life in children with acute respiratory tract infections. JAMA 2017; 318(23):2325–2336. doi:10.1001/jama.2017.18715

Last updated
Clinical Pharmacist, CP, April 2018, Vol 10, No 4;10(4):DOI:10.1211/PJ.2018.20204491

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