My daughter (3 years old) was diagnosed with pneumonia. Are antibiotics a must, or can we wait it out and see how her body responds without medication?
As flu season approaches, this is a dilemma many of us may experience. Antibiotics are the standard of care for children diagnosed with pneumonia. This is mostly due to the fear of complications like respiratory failure, fluid build-up in the lungs, and bacteria spreading to other parts of the body, and concerns that these risks may be higher in the absence of antibiotics. Recent studies support shortening the course of antibiotics to 5 days from the standard 10 days to successfully treat pneumonia in children, but what about not prescribing antibiotics altogether?
A recent study published this year in Jama Network Open set out to answer this very question. Researchers looked at over 100,000 children diagnosed with pneumonia. They compared the outcomes of those who received antibiotics (about 80% of the group) to those who did not. Results showed that 10.7% of the non-antibiotic group failed treatment compared to 8.7% of the antibiotic group. Severe outcomes were observed in 1.1% and 0.7% respectively. These findings suggest that the vast majority of children with pneumonia have a good recovery, whether they receive antibiotics or not. While more research is needed before changing the standard of care for pneumonia in children, we can use this information to make educated decisions for our own children.
I’m a gastroenterologist and am not qualified to tell you whether your child’s pneumonia warrants antibiotics or not. What I can tell you is that the child and adolescent microbiome is vulnerable – especially in the first 3 years of life – and it’s important to be well-informed when making decisions surrounding antibiotics. This study tells us that in most children with pneumonia – especially in those without respiratory co-morbidities, treatment outcomes with and without antibiotics are very similar. Use the information you have at hand, plus your parental intuition, to have an informed dialogue with your child’s healthcare practitioner to arrive at the right decision for your child.
For more information on this topic, check out these Gutbliss resources:
- Episode #6 from The Gutbliss Podcast, To Treat or Not to Treat
- From The Gutbliss Blog, You have to take antibiotics, now what?
- From Dr. Chutkan’s Office Hours series, Origins of the Microbiome
