The Cochrane Library and Treatment for Community Acquired Pneumonia in Children: An Overview of Reviews
Bibliographic record
Abstract
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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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.032 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.009 | 0.007 |
| Bibliometrics | 0.021 | 0.022 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.005 | 0.003 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.013 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".