Should children be spared the pain of the needle?

Most adults hate doctor’s needles and for children the fear is even more acute. But are they always the best form of treatment? A world-first study published by the University of Nottingham suggests that in some cases children who are spared this pain are more likely to recover faster. The research found that children suffering from pneumonia – a disease that affects two-and-a-half million children each year in Europe alone – who were given oral treatment as an alternative to injections recovered as quickly, suffered less pain, required less oxygen therapy in hospital and were able to go home sooner.

The study carried out by researchers at The University of Nottingham and funded by the British Lung Foundation suggests that injections of antibiotics endured by generations of children suffering from pneumonia may be unnecessary and could be replaced with oral doses of the medicine in the majority of cases.

The research involved 243 children in hospitals throughout the UK. It was led by Terence Stephenson, Professor of Child Health, and Dr Maria Atkinson, both of The University of Nottingham’s Medical School.

Published online in the medical journal Thorax, the study is the first in the developed world to compare oral treatment versus intravenous (IV) treatment for children with community-acquired pneumonia, who are unwell enough to need admission to hospital.

Professor Stephenson said: “This is good news for children who hate injections; good news for parents whose children will spend less time in hospital; good news for paediatricians who hate sticking needles in children and good news for the NHS, as fewer beds will be occupied and the treatment is cheaper.”

Dame Helena Shovelton, Chief Executive of the British Lung Foundation, said: “Treating childhood pneumonia will be less painful and distressing for parents, for children and for the health professionals caring for them, thanks to this research. We are very proud to have made this breakthrough possible.”

The research project involved 243 children, enrolled over a 21-month period at eight UK hospitals. Half were randomly assigned to receive a week of oral antibiotic treatment and half to receive antibiotics intravenously.

Follow-up over subsequent weeks showed that both types of treatment are effective in tackling the illness — and the former actually had a number of advantages over the latter. Oral antibiotics are also cheaper than those given via the IV route.

The researchers concluded: “We suggest that in countries like the UK, all but the sickest children with community-acquired pneumonia should be treated with oral amoxicillin initially.

“We expect that the majority of children will still require hospital admission but for a shorter period, to ensure oral medication is tolerated, and temperature and respiratory distress are settling. Most importantly children will be spared the pain and distress that injections cause.”