Antibiotic treatment ofpneumonia andbronchiolitis A prospective randomised study

SUMMARY Routine administration ofantibiotics inthetreatment ofpneumonia andbronchiolitis ininfants andsmallchildren was evaluated inan open randomised prospective trial. From 1979-82 136children between theage of1monthand6 yearswere allocated toone oftwo treatment groupsshortly after their admission toapaediatric ward.GroupA patients were tobe given antibiotics butthose ingroup B were not.Noneofthechildren hadreceived antibiotics before hospital admission. A viral infection was diagnosed in38ofthe72patients fromgroupA andin34ofthe64patients fromgroupB.Respiratory syncytial virus was detected in84%ofthese patients. Samples oftracheal secretions showed no differences between thegroupsinrespect of cytology andbacterial flora. Norwere there any significant differences inthecourseofacute disease, thefrequency offever relapse andpulmonary complications. Fifteen patients fromgroup B were subsequently treated withantibiotics: two ofthesedeveloped secondary purulent infections ofthemiddle earandone showed aslight pleural effusion. Theseresults donotsupport theroutine useofantibiotics ininfants andsmall children admitted tohospital withpneumonia andbronchiolitis.