The Cochrane Library and Treatment for Community Acquired Pneumonia in Children: An Overview of Reviews
Notice bibliographique
Résumé
Abstract Background Globally, pneumonia is the leading cause of death among children and also results in significant morbidity. The most common treatment options include anti‐pyretics and antibiotics. Other treatments include vitamins and over‐the‐counter cough syrup. Objective This overview presents a summary of the results of previous Cochrane reviews on the treatment of community acquired pneumonia (CAP) in children. Methods The Cochrane Database of Systematic Reviews was searched for all systematic reviews examining the treatment of pediatric pneumonia or lower respiratory tract infections. All reviews that were under the heading “pneumonia” on the Cochrane Acute Respiratory Infections (ARI) Group's Topic List and the ARI group were consulted. Data were extracted and entered into tables; data were synthesized using qualitative and quantitative methods. Main Results Eight reviews and one protocol were identified and data were available from seven reviews. Azithromycin and amoxicillin‐clavulanate appeared to be equivalent for CAP in developed countries. In comparing beta‐lactams, one small low‐quality trial showed a higher cure rate with amoxicillin‐clavulanate than with amoxicillin. In comparing macrolides, the efficacy of azithromycin, clarithromycin, and erythromycin appeared to be equal. Azithromycin was better tolerated than was amoxicillin‐clavulanate. For CAP in developing countries, the failure rate was lower for amoxicillin than for co‐trimoxazole. Initial therapy with oral or parenteral antibiotics were equivalent in children with non‐severe pneumonia. A 3‐day course of amoxicillin or of co‐trimoxazole had an equivalent clinical cure rate, treatment failure rate and relapse rate when compared to a 5‐day course. Inconsistent outcomes were shown in studies of vitamin A for therapy of non‐measles pneumonia. There were insufficient children in the studies of over‐the‐counter medications for cough in children with pneumonia to reach meaningful conclusions. Conclusions Although thousands of children have been enrolled in trials of CAP treatments, limited conclusions can be reached about the ideal treatment, route and duration in developed or developing countries and for children of various ages. The primary reason for this is the multitude of interventions studied in diverse populations. Another major problem is that the diagnosis of pneumonia was often clinical rather than radiographic—often by necessity in developing countries. Even when pneumonia was diagnosed radiographically, differentiating viral from bacterial pneumonia was often not practical. Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. The Cochrane Collaboration
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,004 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,002 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».