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Antibiotics for chronic pulmonary infection in children with a neurodisability (neurodevelopmental disorder)
Juliane Rf Sanner1, Kamini Jain2, Jane Williams1
1Department of Family Health, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Insights
This review found no completed studies on antibiotic treatment for chronic pulmonary infections in children with neurodisability. More research is needed to determine the best treatment options for these vulnerable young patients.
Area of Science:
- Pediatric Pulmonology
- Infectious Diseases
- Neurology
Background:
- Neurodisability encompasses neurological, neuromuscular, and developmental conditions affecting children and young people.
- These conditions often lead to challenges with mobility, feeding, and airway clearance, increasing susceptibility to pulmonary infections.
- Chronic pulmonary infections are a significant concern, often necessitating hospital care and posing challenges for complete eradication.
Conclusions:
- There is a significant lack of evidence regarding antibiotic treatment for chronic pulmonary infections in children and young people with neurodisability.
- Further research is urgently required to establish effective and safe treatment strategies for this population.
Background:
'Neurodisability' refers to a group of conditions that result primarily from a neurological problem (e.g. cerebral palsy), neuromuscular problem (e.g. a muscular dystrophy) or developmental problems (e.g. developmental impairment, Down syndrome). Children and young people with these conditions may have similar problems with mobility, feeding and airway clearance. Chest and breathing problems (including pulmonary infections) are commonly experienced by children and young people with neurodisabilities and are often a cause for them requiring hospital care. For those who are unable to completely clear their airway of secretions, or have frequent infections, pulmonary infections may not be able to be completely eradicated and therefore become chronic. It is unclear what treatment is best for children and young people in this position.
Objectives:
To assess the effectiveness and adverse effects of antibiotic treatment for chronic pulmonary infection in children and young people living with a neurodisability, including quality-of-life measures, effects on hospitalisation and healthcare contacts.
Search Methods:
We searched the Cochrane Airways Trials Register, Cochrane Acute Respiratory Infections Group Register of Trials (CARIGRT), Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (Ovid), Embase (Ovid), Cumulative Index to Nursing and Allied Health Literature (CINAHL), OpenGrey (www.opengrey.eu) and three trials registries up to 8 February 2022. Additionally, we identified related systematic reviews through Epistemonikos.org (8 February 2022) and searched reference lists of these.
Selection Criteria:
All randomised controlled trials of antibiotic therapy for chronic pulmonary infection in children and young people up to the age of 18 living with a neurodisability were eligible.
Data Collection And Analysis:
Two independent review authors screened results of the searches against predetermined inclusion criteria, resolving any discrepancies by discussion.
Main Results:
We identified a total of 1968 independent records through our searches, of which we assessed six full-text articles for eligibility. We identified one ongoing study as well as one related substudy but did not identify any completed studies eligible for inclusion in this systematic review.
Authors' Conclusions:
The findings of this systematic review highlight a lack of evidence in the antibiotic treatment of chronic pulmonary infection in children and young people up to the age of 18 living with a neurodisability. Further research examining this topic is therefore required.
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