While vaccines, mosquito nets and other health measures have saved millions of children younger than 5 in the last decade, death rates from pneumonia, sepsis and meningitis among babies in the first weeks of life have remained stubbornly high.
Now researchers have found that giving oral antibiotics to newborns in danger, a simpler protocol than the injectable antibiotics recommended by the World Health Organization, could save the lives of many of the 630,000 newborns who die each year.
As a result of three large studies published in The Lancet and Lancet Global Health recently, the WHO will soon be revising its guidelines, Tarik Jasarevic, an organization spokesman said.
Current guidelines call for babies with symptoms of dangerous bacterial infections to receive injectable antibiotics for seven to 10 days, a protocol that usually requires hospitalization.
But for many parents in poor countries, that is impossible. Traveling to a distant hospital may cost too much, and parents may fear unfamiliar surroundings or be unable to afford to leave their farms, jobs and other children for long, so babies often die.
A study in Pakistan found that only 24 percent of parents accepted hospitalization for their infants, and even when the study team paid for transportation and helped with admissions, only half did so.
The new studies, two in Africa and one in Bangladesh, divided about 8,400 babies panting for breath, a symptom of pneumonia, into groups. Some received the WHO protocol; others got fewer antibiotic injections and a week of liquid amoxicillin. Overall, the cure rates were similar and more families adhered to the oral regimen.
Ideally, the authors said, lightly trained health workers at local clinics could administer two injections of antibiotics to sick infants in a day and then send parents home with a bottle of amoxicillin.
“These results should provide a sound basis for policymakers and experts to now empower and train staff at first-level outpatient units and to ensure proper drugs and equipment are available,” said Dr. Steve Wall, an adviser to Save the Children.
The studies were commissioned by the WHO and supported by the Bill & Melinda Gates Foundation, Save the Children, the U.S. Agency for International Development, the Johns Hopkins Bloomberg School of Public Health and local health ministries.