Dari website Prof Iwan Darmansjah :
http://www.iwandarmansjah.web.id/popular.php?id=170

Jangan Beri Antibiotik Pada Anak Untuk Batuk Biasa

Cough illness in the well-appearing child:
Antibiotics are NOT the answer.
1 Cough illness/bronchitis is principally caused by viral pathogens. 2
Airway inflammation and sputum production are non-specific responses and
do not imply a bacterial etiology.
Authors of a meta-analysis of six randomized trials (in adults) concluded
that antibiotics were ineffective in treating cough illness/bronchitis. 3
Antibiotic treatment of upper respiratory
infections do not prevent bacterial complications
such as pneumonia.

Berikut artikel dari CDC :
Cough illness in the well-appearing child: Antibiotics are
NOT the answer.
CAREFUL ANTIBIOTIC USE

COUGH ILLNESS/BRONCHITIS1

Cough illness/bronchitis is principally
caused by viral pathogens. Airway inflammation and sputum production are
non-specific responses and do not imply a bacterial etiology.

Authors of a meta-analysis of six randomized trials (in adults) concluded
that antibiotics were ineffective in treating cough illness/bronchitis.
Antibiotic treatment of upper respiratory
infections do not prevent bacterial complications
such as pneumonia.

@ Do not use antibiotics for:
Cough <10-14 days in well-appearing child
without physical signs of pneumonia.

@ Consider antibiotics only for:
Suspected pneumonia, based on fever with focal
exam, infiltrate on chest x-ray, tachypnea, or
toxic appearance. Prolonged cough (>10-14 days without improvement) may
suggest specific illnesses (e.g. sinusitis) that warrant antibiotic
treatment.
Treatment with a macrolide (erythromycin) may be warranted in the child
older than 5 years when mycoplasma or pertussis is
suspected.

When parents demand antibiotics...

Acknowledge the child’s symptoms and discomfort.
Promote active management with non-pharmacologic treatments.
Give realistic time course for resolution.
Share the CDC/AAP principles and pamphlets with parents to help them
understand when the risks of antibiotic treatment outweigh the benefits.

References
1.OBrien KL, Dowell SF, Schwartz B, Marcy SM,
Phillips WR, Gerber MA. Cough illness/bronchitisprinciples
of judicious use of antimicrobial agents.
Pediatrics 1998;101:178-181.
2.Chapman RS, Henderson FW, Clyde WA, Collier
AM, Denny FW. The epidemiology of tracheobronchitis
in pediatric practice. Am J Epidemiol
1981;114:789-797.
3.Orr PH, Scherer K, Macdonald A, Moffatt MEK.
Randomized placebo-controlled trials of antibiotics for
acute bronchitis: a critical review of the literature.
J Fam Pract 1993;36:507-512.
4.Gadomski AM. Potential interventions for preventing
pneumonia among young children: lack of effect
of antibiotic treatment for upper respiratory infections.
Pediatr Infect Dis J 1993;12:115-120.
5.Wald E. Management of Sinusitis in infants and
Children. Pediatr Infect Dis J 1988;7:449-452.
6.Denny FW, Clyde WA, Glezen WP. Mycoplasma
pneumoniae disease clinical spectrum, pathophysiology,
epidemiology and control. J Infect Dis 1971;123:74-92.


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