Short-course antibiotic treatment for community-acquired alveolar pneumonia in ambulatory children: a double-blind, randomized, placebo-controlled trial. Children commonly show a mixed pattern of disease (bacterial, viral with or without airway obstruction), and some antibiotic re-treatment may have been for self-limiting disease unlikely to respond to antibiotics. Second, the trial findings do not inform total treatment duration for children initially admitted to the hospital.

There were two interventions in this study: dose of amoxicillin (35-50mg/kg/day or 70-90mg/kg/day) and duration of treatment from discharge (3 or 7 days). Duration of CAP symptoms was analyzed using time-to-event methods, restricted to children with the particular symptom at enrollment, until the first day the symptom was reported as absent.

Results Of 824 participants randomized into 1 of the 4 groups, 814 received at least 1 dose of trial medication (median [IQR] age, 2. The primary analysis and 3 prespecified analyses are shown for both randomizations including all systemic antibacterial re-treatments, only re-treatments for community-acquired pneumonia (CAP) or chest infection, and by severe CAP subgroups. Including additional information from family physicians regarding any subsequent antibiotic prescriptions (n = 147), the primary end point was evaluable for 789 (97%) children, with the remaining 25 providing data up to the point of last contact. Given a 15% antibiotic re-treatment rate based on internal pilot data, 15% loss to follow-up, and assuming no interaction between the dose and duration interventions, the sample size of 800 participants was estimated to achieve 90% power.

Pediatric Emergency Medicine, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, United Kingdom. Re-treatment rates in both the current trial and the SAFER trial are similar to the 10% to 11% previously observed for amoxicillin-treated lower respiratory tract infection in UK general practice. Effect of Amoxicillin Dose and Treatment Duration on the Need for Antibiotic Re-treatment in Children With Community-Acquired Pneumonia : The CAP-IT Randomized Clinical Trial.Two hundred eighteen (98%) children who were inpatients and 24 (4%) who were discharged directly from the ED had received β-lactam antibiotics (100% treated for <48 hours and 185 (76%) <24 hours; eTable 5 in Supplement 2). As well as comparing duration, dosing was also studied, with half the participants in each duration group receiving a lower dose (35-50 mg/kg) and the other half a higher dose (70-90 mg/kg). Causes of severe pneumonia requiring hospital admission in children without HIV infection from Africa and Asia: the PERCH multi-country case-control study.

In contrast to the accepted paradigm that higher doses are better for the treatment of severe infections, we did not find lower doses to be disadvantageous for children in CAP-IT in terms of clinical outcome, side effects or emergence of resistance. Cap-It Financial Limited (Company number 09009529) is regulated and authorised by the Financial Conduct Authority (FRN: 700118), with its registered office at 2 London Wall Place 6th Floor, 2 London Wall Place, London, England, EC2Y 5AU. To Cap It All is the story of legendary Port Vale manager John Rudge, who managed the side for a record 19 years before crossing the great Potteries divide to join rivals Stoke City.Secondary outcomes include adverse events, severity and duration of parent-reported CAP symptoms, adherence and antibiotic resistance. A sensitivity analysis including only re-treatments after day 3 is shown for the duration randomization. Striking an appropriate balance between minimising drug exposure whilst maintaining effective treatment is key for antimicrobial stewardship. However, the most appropriate total daily dose of oral amoxicillin treatment has not been investigated in any trial, and it is unclear whether evidence supporting 3-day treatment can be generalized from low- and middle-income countries to high-income secondary care settings with differing diagnostic criteria. Capital Markets Elite Group (UK) Limited is authorised and regulated by the Financial Conduct Authority (FRN 583632) and registered under the laws of England and Wales, (company number 07832612).

Children randomized to 3 days of amoxicillin were more likely to complete their full treatment course compared with those randomized to a 7-day course (98% vs 91%). Position paper: recommended design features of future clinical trials of antibacterial agents for community-acquired pneumonia.Lyttle MD, Bielicki JA, Barratt S, Dunn D, Finn A, Harper L, Jackson P, Powell CVE, Roland D, Stohr W, Sturgeon K, Wan M, Little P, Faust SN, Robotham J, Hay AD, Gibb DM, Sharland M; PERUKI, GAPRUKI and the CAP-IT trial team. Pernica JM, Harman S, Kam AJ, Carciumaru R, Vanniyasingam T, Crawford T, Dalgleish D, Khan S, Slinger RS, Fulford M, Main C, Smieja M, Thabane L, Loeb M. Alu-Cab and Smartcaps, Rooftop Tents, Portable Heaters, Fridges and all of your outdoor cooking and furniture needs from GCI Outdoors, KUMA and Helinox. Chris Archer – Started on a hardware maintenance role looking after companies hardware contract within a small team.