Researchers Urge WHO to Issue New Guidelines for Childhood Pneumonia

Researchers studying the treatment of severe pneumonia in children have asked the World Health Organization, the health agency of the United Nations, to give fresh recommendations regarding treatment of severe childhood pneumonia.

Researchers made the recommendations Thursday after determining that children with severe pneumonia could be treated with oral antibiotic drugs at home as it had the same impact as treatment with intravenously administered drugs at hospitals as advised by the WHO.

Researchers arrived at these conclusions based on their study of 2,037 children aged between three and five years in Pakistan. In their study, researchers looked at children with severe pneumonia in Pakistan, who came for treatment to hospitals in seven locations.

The hospitals sent half of the sick children back and asked them to take amoxicillin, an antibiotic, orally in syrup form. The remaining half were kept at the hospitals and provided with an intravenous version of an antibiotic that worked more or less the same – ampicillin.

The study determined that treating the children at home had the same effect as treating them at hospitals. Five children died in all within 14 days of becoming the subjects of the study, of whom only one was treated at home; the remaining four were treated at the hospital.

The current WHO advisory asks that children with severe pneumonia can be treated at hospitals with intravenously administered antibiotics. However, this advisory cannot be considered realistic in many a developing nation, as there is the possibility of children in such nations having no access to a hospital. There was also the cost factor, researchers said; oral treatment at home was way cheaper than intravenous treatment at a hospital.

Pneumonia has a feared reputation across the world, especially in South Asia and sub-Saharan Africa, of being one of the main child killers. It is responsible for the deaths of approximately 2 million of the 10 million children below the age of five years who die each year across the world.

One of the researchers, Dr. Donald Thea of the Boston University School of Public Health, said, “It exceeds malaria, it certainly exceeds HIV and it exceeds diarrheal diseases, too.”

According to the researchers, the current WHO guides may be impractical because of lack of access to hospitals for children living in the remote parts of developing countries. Also, there was minimal chance of infections occurring with oral treatment, as it ruled out the use of unclean needles.

Writing in the Lancet medical journal, the researchers said, “Safe community-based treatment alternatives will substantially increase the number of children who can receive effective care and save lives and money.”

The International Center for Diarrheal Disease Research in Bangladesh, Dr. Shams El Arifeen, and Dr. Abdullah Baqui from the John Hopkins University in Baltimore said the study was a ‘milestone’. “The potential impact here is enormous, particularly for the many children with severe pneumonia who are referred to hospitals but never reach them,” they said.