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
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.