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29271 - Management Prophylaxis of Cardio-respiratory...

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Management & Prophylaxis of Cardio-respiratory illnesses DR SWATI BHAVE Senior consultant Pediatric & Adolescent medicine Indraprastha Apollo Hospital New D elhi Member Standing committee ASPID ( Asian Society of Pediatric infectious disease ( 2000-03) ) Standing committee IPA ( International Pediatric Association 2001-07) President 2000 Indian Academy of Pediatrics
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Prophylactic antibiotics for cystic fibrosis Three studies, totaling 177patients aged 0-7 years on enrollment, were suitable for inclusion in the review. A reduced prevalence of Staphylococcus aureus in the respiratory secretions was seen in children receiving anti- staphylococcal antibiotic prophylaxis, although no effect was seen on other common pathogens. One eligible study showed a shorter duration of hospital admissions in the second year ofl ife, in patients receiving prophylaxis. No effect on infant lung function has been shown after one year of prophylactic treatment. Data are not available on adverse effects of the interventions. There was a trend towards a lower cumulative isolation Update of: Cochrane Database Syst Rev. 2000;(2):CD001912. . Smyth A, Walters S.
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There was a trend towards a lower cumulative isolation rate of P aeruginosa in the prophylaxis group,after three years. However, as the duration of the studies reviewed has been oft hree years or less, conclusions cannot be drawn about the long term effects of prophylaxis on acquisition of P. aeruginosa and survival. REVIEWER'SCONCLUSIONS: Anti-staphylococcal antibiotic prophylaxis may be of benefit when commenced early in infancy and continued up to three years of age. There is insufficient evidence from this review to say whether use in older children, or adults, or for periods of over three years is beneficial.
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