title: Antibiotics for preventing pneumonia in children with measles.
abstract: BACKGROUND
  Measles causes more than a million deaths a year, of which most are children under five years of age who die from pneumonia.
  
  
  OBJECTIVE
  The objective of this review was to assess the effects of antibiotics given to children with measles on reducing pneumonia or mortality, and to assess whether antibiotics should be given to all children with measles in communities with a high fatality rate.
  
  
  METHODS
  We searched MEDLINE (1966 - 1999), EMBASE (1980-1999) and the specialized trials register of the Acute Respiratory Infections Group in August 1999, and all relevant journals in the University of Melbourne medical library for the years 1935-46.
  
  
  METHODS
  Randomised or controlled trials of antibiotics for children with measles.
  
  
  METHODS
  Two reviewers independently extracted data and assessed trial quality.
  
  
  RESULTS
  Six trials with 1304 children were included. All but one of the trials were unblinded, and randomisation was either not described or was by alternate allocation. In four studies, the incidence of pneumonia in the control group was similar to that in the antibiotic prophylaxis group; in the other two studies, the incidence of pneumonia was unusually high in the control group so these children had a higher complication rate than the antibiotic group. Four of the 764 children given antibiotics died compared with one of the 637 controls.
  
  
  CONCLUSIONS
  The quality of the trials reviewed was poor, and they provide very weak evidence for giving antibiotics to all children with measles. Available evidence suggests that antibiotics should be given only if a child has clinical signs of pneumonia or other evidence of sepsis.
authors.affiliation: Intensive Care Unit, Royal Children's Hospital, Flemington Road, Parkville, AUSTRALIA, VIC 3052. shannf@cryptic.rch.unimelb.edu.au
authors.forename: F
authors.initials: F
authors.lastname: Shann
authors.forename: R M
authors.initials: RM
authors.lastname: D'Souza
authors.forename: R
authors.initials: R
authors.lastname: D'Souza
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D006801:Humans; D008457:Measles / Q000150:complications* / Q000188:drug therapy*; D011014:Pneumonia / Q000188:drug therapy / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic
chemical_list: D000900:Anti-Bacterial Agents