One in five babies worldwide develops a severe bacterial infection, including pneumonia and sepsis, resulting in the death of an estimated 700,000 infants. New research shows that young infants can be safely and effectively treated in their community with a simplified antibiotic drug regimen.
The World Health Organization recommends that infants who become severely ill with bacterial infections be treated with a series of antibiotic injections in the hospital.
But many parents refuse hospital care or cannot access it due to a lack of transportation, high cost and distance from home.
Now, new, more accessible drug regimens - combining oral and injectable antibiotics - given in outpatient settings appear to be just as effective as hospital care.
Several studies published in the journal The Lancet Global Health demonstrate the effectiveness of simplified antibiotic regimens. The trials, involving thousands of infants, were carried out in the Democratic Republic of Congo, Kenya, Nigeria and India.
In Bangladesh, researchers led by Abdullah Baqui from Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland compared two simplified regimens of oral and injectable antibiotics to the recommended standard course of seven daily antibiotic injections in sick infants.
The risk of failure in the simplified treatment strategy was 8 percent compared to 10 percent in the group receiving daily injections.
Researchers in Africa also found a combination of oral and injectable antibiotics in diverse settings worked as well as hospital-based treatment.
Baqui said a modified antibiotic schedule for treatment of severe infection in newborns, using fewer injections, offers an attractive alternative to hospitalization.
“It will expand treatment options to settings where hospital care is not available. But still we have to work to develop delivery strategies,” said Baqui.
The addition of oral antibiotics in the treatment of severe infections in infants means better compliance because fewer shots have to be given.
Scaling up for community based treatment of sick infants, according to Baqui, means training local health care workers and strengthening health care systems, not a simple task.
Baqui said the WHO is considering modifying its recommendations to include a simplified treatment regimen for severe bacterial infections in young babies.
“We think the WHO policy will be revised. It probably will take a few more months, but yes, we’re working with WHO,” said Bacqui.
Bacqui added that the introduction of simplified antibiotic treatment strategies at the community level will mean more infants will receive potentially life-saving therapy.