Antibiotics for Respiratory Tract Infections in Down's Syndrome

Sarfaroj Khan 


October 12, 2020


  • In children with Down's syndrome (DS), the prescription of antibiotics following respiratory tract infection (RTI)-related general practitioner (GP) consultations did not reduce the overall risk of subsequent RTI-related hospitalisation.

  • However, the risk of hospitalisation was reduced in infants with DS (0-1 year of age).

Why this matters

  • Findings suggest a possible risk reduction for infants with DS which warrants further research and subsequent consideration in updated guidelines.

Study design

  • A retrospective cohort study of 992 children with DS and 4874 control participants managed by UK National Health Service (NHS) GPs and hospitals as identified in Clinical disease research using LInked Bespoke studies and Electronic health Records (CALIBER; 1997-2010).

  • Funding: None disclosed.

Key results

  • The risk of RTI-related hospitalisation within 28 days of an RTI-related GP consultation was not significantly reduced with antibiotic treatment in children with DS (risk with antibiotics, 1.8%; without 2.5%; risk ratio [RR], 0.699; 95% CI, 0.471-1.036; P=.0913).

  • The results were similar in control participants (RR, 0.758; 95% CI, 0.482-1.191; P=.2553).

  • In subgroup analysis, the risk of RTI-related hospitalisation was reduced with antibiotic treatment in infants with DS (adjusted OR, 0.260; 95% CI, 0.077-0.876; P=.0297) after adjusting for covariates.

  • There was no reduction in risk for controls, overall or across subgroups.


  • Retrospective design.


Manikam L, Lakhanpaul M, Schilder AG, Littlejohns P, Cupp MA, Alexander EC, Hayward A. Effect of Antibiotics in Preventing Hospitalisations from Respiratory Tract Infections in Children with Down Syndrome. Pediatr Pulmonol. 2020 Sep 30 [Epub ahead of print]. doi: 10.1002/ppul.25100. PMID: 32997386 View abstract

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.


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