Can Shorter Courses of Antibiotics Prevent Resistance?

The National Institutes of Health (NIH) recently announced that the National Institute of Allergy and Infectious Diseases (NIAID) will be sponsoring a clinical trial to evaluate the use of shorter-term antibiotics in children with lung infections.

The participating physicians will be enrolling up to 400 children in the study to determine whether a 5-day course of antibiotics can effectively treat community-acquired pneumonia in children compared with a 10-day course, according to a press release from the NIH. The researchers will use a novel evaluation approach developed by a team of experts in antibiotic resistance.

The spread of antibiotic-resistant superbugs has recently been under the microscope, since multiple deaths have been attributed to these infections. Adults and children have been affected by the spread, with more cases being reported each year.

Antibiotic resistance can present problems for patients of all ages, but very young and elderly patients are especially at risk when an infection becomes resistant to antibiotics.

Community-acquired pneumonia is a condition that can potentially be very serious in children, and often results in hospitalization for this population. Viruses and bacteria, such as Streptococcus pneumoniae, are the typical causes of infection in young, pre-school-aged children, while Mycoplasma pneumoniae and fungal infections are common causes in older children, the NIH reported.

Regardless of the cause, children who develop community-acquired pneumonia typically receive the first-line treatment of a 10-day course of amoxicillin.

The SCOUT-CAP trial will enroll children aged between 6 months and 6-years-old who were diagnosed with community acquired pneumonia and treated in outpatient clinics, urgent care clinics, and emergency departments. All patients included will have shown a clinical improvement in their condition prior to being enrolled in the trial, according to the NIH.

Of those enrolled, 200 children will receive standard treatment with amoxicillin, amoxicillin-clavulanate combination, and cefdinir, and 200 will receive a shorter course of treatment.

It will also involve the use of an evaluation approach that assesses treatment strategies to reduce exposure to antibiotics in children, which will likely prevent them from developing antibiotic resistance. This method was created by the NIAID-funded Antibacterial Resistance Leadership Group, which focuses on creating and conducting antibiotic resistance research.

The clinical trial will include Duke University, Vanderbilt University, Cincinnati Children’s Hospital Medical Center, Children’s Hospital of Philadelphia, and Children’s Hospital of Pittsburgh-University of Pittsburg, according to the NIH.

“Finding new strategies for treating bacterial infections and making better use of existing antibiotic medications are major areas of focus for researchers,” said NIAID Director Anthony S. Fauci, MD. “This study aims to determine whether we can effectively treat young children for community-acquired pneumonia with a shorter course of antibiotic therapy than is currently the standard. Using only the amount of medication that is needed — and no more — not only is good for patients but could also help conserve the long-term effectiveness of available drugs.”