Dialing Down Offense to Fight Bacteria Better

Narrow spectrum antibiotics for pneumonia worked as well as broad spectrum antibiotics

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) Antibiotics completely revolutionized the way medicine is practiced. But they brought a downside too — when bacteria learned to fight back.

Using antibiotics too much, or ones that fight many different bacteria, can help those bacteria develop a resistance to the medications.

A recent study found that using antibiotics that target particular bacteria had similar outcomes to using antibiotics that fight a wide range of bacteria.

This study focused on treatment of pneumonia in children. The researchers learned that using the more specific antibiotic could work effectively.

"Ask your doctor about antibiotic use."

The study, led by Mary Ann Queen, MD, of the Division of Hospital Medicine at Children's Mercy Hospitals and the University of Missouri School of Medicine in Kansas City, compared the effectiveness of two types of antibiotics for pneumonia in children.

Broad-spectrum antibiotics are antibiotics that fight a wide range of bacteria that cause disease. By contrast, narrow-spectrum antibiotics only fight a select few bacteria that cause disease.

The researchers wanted to find out if evidence supported the recommendation to use narrow-spectrum antibiotics instead of broad-spectrum ones for pneumonia without complications.

The researchers examined the medical records of 492 children, aged 2 months to 18 years old, who were treated for pneumonia at four children's hospitals in 2010.

The researchers looked at whether the patients had been given broad-spectrum or narrow-spectrum antibiotics and tried to match the patients based on their disease characteristics.

Then the authors looked at how long the patients remained at the hospital, whether they were readmitted within a week of discharge, what the costs were per patient, how long the patients' fevers lasted and how long the patients required oxygen support.

Of all the patients, 52 percent received narrow-spectrum antibiotics and 48 percent received broad-spectrum antibiotics.

When the researchers compared outcomes, they found that the patients who received narrow-spectrum antibiotics spent 10 hours fewer in the hospital than those receiving broad-spectrum antibiotics.

Meanwhile, the length of time the children received oxygen, the length of time they had a fever, and their rates of readmission to the hospital were not different between the two groups.

Overall, the researchers also did not find a significant difference in the average hospital or pharmacy costs for either group.

"Compared with broad-spectrum agents, narrow-spectrum antibiotic coverage is associated with similar outcomes," the researchers wrote.

"Our findings support national consensus recommendations for the use of narrow-spectrum antibiotics in children hospitalized with community-acquired pneumonia," they wrote.

The advantage of using narrow-spectrum antibiotics first is that "use of broad-spectrum antibiotics has been shown to increase the risk of developing subsequent infections with resistant organisms," the researchers wrote.

In other words, first using antibiotics that fight a wide range of bacteria might increase the resistance of bacteria against those antibiotics so that those bacteria are harder to fight with antibiotics later on.

The study was published December 9 in the journal Pediatrics. The research did not use external funding. The authors declared no conflicts of interest.

Review Date: 
December 9, 2013
Last Updated:
December 9, 2013