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Updated: Jun 14, 2026
11:17
Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
Risk-benefit analysis of restricting antimicrobial prescribing in children: what do we really know?
Tamara Keith1, Sonia Saxena, Joanna Murray
1Department of Primary Care and Social Medicine, Imperial College London, London, UK.
Current Opinion in Infectious Diseases
|April 9, 2010
Summary
Antibiotics offer minimal benefit in preventing serious complications of common childhood respiratory infections like acute otitis media and pneumonia. Research should focus on identifying risk factors and optimizing monitoring for antibiotic use in children.
Area of Science:
- Pediatrics
- Infectious Diseases
- Antimicrobial Stewardship
Background:
- Childhood respiratory infections are often self-limiting, yet antibiotic prescribing remains high.
- Concerns about rare serious complications drive antibiotic use despite guidance against it.
- This review examines antibiotic efficacy in preventing severe outcomes of upper respiratory tract infections (URTIs) in children.
Purpose of the Study:
- To review evidence on the role of antibiotics in preventing serious complications of childhood URTIs.
- To assess the risk-benefit balance of antibiotic use in pediatric respiratory infections.
Main Methods:
- Literature search for studies on antibiotic use and complications of childhood respiratory infections.
- Analysis of observational data to calculate excess risk of complications without antibiotics.
Main Results:
- An observational study indicated an excess risk of suppurative complications of 3.8 per 10,000 children not receiving antibiotics.
- No data were found on the effect of antibiotics on the risk of brain abscess after sinusitis in children.
- Evidence suggests limited benefit of antibiotics in preventing mastoiditis, quinsy, or pneumonia.
Conclusions:
- Antibiotics show little benefit in preventing mastoiditis, quinsy, or pneumonia following common childhood respiratory infections.
- Future research should identify key risk factors for these complications.
- Optimizing long-term monitoring is crucial for reassessing the risk-benefit of antibiotic prescriptions.
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