Clinical Trial: Prophylactic Antibiotics in Measles

Study Status: Completed
Recruit Status: Completed
Study Type: Interventional

Official Title: Prophylactic Antibiotics in Measles Infection. A Community-Based Randomised Double-Blind Placebo-Controlled Trial in Guinea-Bissau

Brief Summary: Objective It is the objective to test whether the use of prophylactic antibiotics in measles infection will reduce the incidence of post-measles pneumonia and/or admissions to hospital with 50%. The possible impact on other complications of severe measles will also be measured.

Detailed Summary:

Background The case-fatality rate of measles in developing countries is still high, particularly in infants. It is estimated that measles is responsible for more than one million deaths per year, and that most of these deaths are due to complications of the disease.

Most of the severe complications of measles in developing countries are due to secondary bacterial and viral infections causing pneumonia and diarrhea.

A study from the fifties showed no benefit from treating measles cases prophylactically with antibiotics, and this together with the fear for developing antibiotic resistance has given rise to the dogma that it is harmful to give prophylactic antibiotics in measles infection.

A more recent study from Niakhar, a rural area of Senegal, has shown that children treated with prophylactic antibiotics had a lower frequency of respiratory complications. In 1987 it was decided that all children younger than 3 years of age seen within the first 2 weeks of the onset of measles symptoms should be treated with the antibiotic trimethoprim-sulfamethoxazole for 7 days irrespective of whether they had signs of bacterial infection at the time of clinical examinations. Children younger than 3 years of age who had received prophylactic antibiotics were less likely to have respiratory symptoms on days 8 to 15 of illness than children of the same age group who had not received antibiotics because they were seen for the first time on days 8 to 15 (relative risk, 0.37 (0.15 to 0.94)). Further, the case-fatality rates adjusted for age declined 2-fold between 1983-1986 and between 1987-1991 (mortality ratio, 0.41 (0.21 to 0.81)).

As this study was not an unbiased evaluation, it would be desirable to do a randomized doubleblind placebocontr
Sponsor: Bandim Health Project

Current Primary Outcome:

  • Post-measles pneumonia
  • Admission to hospital


Original Primary Outcome:

  • - Post-measles pneumonia
  • - Admission to hospital


Current Secondary Outcome:

  • Weight gain or loss during the first month of infection
  • Diarrhoea
  • Severe fever
  • Oral thrush
  • Stomatitis
  • Conjunctivitis
  • Otitis media


Original Secondary Outcome:

  • - Weight gain or loss during the first month of infection
  • - Diarrhoea
  • - Severe fever
  • - Oral thrush
  • - Stomatitis
  • - Conjunctivitis
  • - Otitis media


Information By: Bandim Health Project

Dates:
Date Received: September 9, 2005
Date Started: January 1998
Date Completion:
Last Updated: February 25, 2008
Last Verified: February 2008