Chest radiograph in acute respiratory infections in children.
BACKGROUND
Chest radiography is widely used in children with acute lower respiratory infections, but the benefits are unknown.


OBJECTIVE
To assess the effects of chest radiography for children with acute lower respiratory infections.


METHODS
The searches were updated in November 2004. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 1, 2005), MEDLINE (1966 to February, Week 1 2005) and EMBASE (January 1990 to September 2004). We contacted experts in the fields of acute respiratory infections and paediatric radiology to locate additional studies.


METHODS
Randomised or quasi-randomised trials of chest radiography in children with acute respiratory infections.


METHODS
One reviewer extracted data and assessed trial quality.


RESULTS
We identified only one trial of 522 participants, which was performed by the review authors. The participants were ambulatory children aged two months to five years. Forty-six per cent of both radiography and control participants had recovered by seven days (odds ratio (OR) 1.03, 95% confidence interval (CI) 0.64 to 1.64). Thirty-three per cent of radiography participants and 32% of control participants made a subsequent hospital visit within four weeks (OR 1.02, 95% CI 0.71 to 1.48). Three per cent of both radiography and control participants were subsequently admitted to hospital within four weeks (OR 1.02, 95% CI 0.40 to 2.60). There were no deaths in either group.


CONCLUSIONS
There is no evidence that chest radiography improves outcome in ambulatory children with acute lower respiratory infection. The findings do not exclude a potential effect of radiography, but the potential benefit needs to be balanced against the hazards and expense of chest radiography. The findings apply to ambulatory children only.
Swingler
G H
GH
School of Child and Adolescent Health, ICH Building, Red Cross Children's Hospital, Klipfontein Road, Rondebosch, Cape Town, South Africa, 7700. swingler@ich.uct.ac.za
Zwarenstein
M
M
D000208:Acute Disease; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D013902:Radiography, Thoracic; D012141:Respiratory Tract Infections / Q000000981:diagnostic imaging*