A NIAID-sponsored randomized, double-blind, placebo-controlled trial study has shown that short-course (five day) antibiotic treatment is superior to standard (10 day) treatment of community-acquired pneumonia (CAP) in children age 6 months to 5 years. Both treatment strategies were effective in treating CAP.  However, scientists have come to recognize that using only the amount of antibiotics that is needed—and no more—not only is good for patients but also helps conserve the long-term effectiveness of available antibiotics. The results of the study were presented during the ID Week 2020 online conference.

The clinical trial, which began in October 2016 and ended in December 2019, involved 380 children with CAP, a common childhood infection that may lead to hospitalization. To be eligible for the study, children had to show improvement after the first few days of taking antibiotics. Patients were enrolled at eight U.S. medical centers, all part of NIAID’s Vaccine and Treatment Evaluation Units.

The trial, run in collaboration with the NIAID-funded Antibacterial Resistance Leadership Group, used an innovative design and evaluation method called the Desirability of Outcome Ranking. Researchers designed the trial to assess the best treatment strategies with a goal of reducing children’s exposure to antibiotics and ultimately reducing the potential for developing resistance to antibiotics.

The trial enrolled children who had clinically responded to conventional oral antibiotics after approximately day five of treatment. Enrolled children were randomized to receive either five more days of antibiotics or placebo. Roughly half of the children involved received the standard 10-day course.

Viruses and bacteria (specifically Streptococcus pneumoniae) are the most common causes of CAP in preschool-aged children. The current standard of first-line treatment for young children diagnosed with CAP is a 10-day course of the antibiotic amoxicillin. Data from this trial have the potential to inform treatment guidelines and reduce the amount of antibiotics used in children.

For more information about the clinical trial, see ClinicalTrials.gov (identifier NCT02891915).

This project has been funded in whole or in part with Federal funds from NIAID under award UM1AI104681 to Duke University and VTEU contracts to Cincinnati Children’s Hospital Medical Center (Contract No. HHSN272201300016I), Duke University (Contract No. HHSN272201300017I), and Vanderbilt University (Contract No. HHSN272201300023I).