Il placebo è efficace come l’amoxicillina nella cura della bronchite acuta: i risultati di un RCT in doppio cieco

Placebo is as effective as amoxicillin in the treatment of acute bronchitis: results of a double-blind RCT In this study conducted at the primary care level in UK, the efficacy of amoxicillin antibiotic therapy on the duration of symptoms in uncomplicated lower respiratory tract infections (excluding pneumonia) in children was compared with placebo. Inclusion criteria matched those commonly used for the diagnosis of acute bronchitis both in clinical practice and in previous Cochrane reviews. 432 children were randomized to the antibiotic (n=221) or placebo (n=211) group. Parents completed a diary of symptoms and daily activities for at least 1 week and until persistence of symptoms in the 4 weeks following randomization. The average duration of symptoms was not significantly different in the 2 groups (5 days in the antibiotic group vs. 6 days in the placebo group), nor in subjects belonging to specific subgroups with symptom severity in which antibiotic is commonly prescribed. Despite the limitations related to the subjective evaluation of the outcomes, the study allows us to conclude that, in the absence of clinical suspicion of pneumonia, in most children with lower respiratory tract infections, doctors should provide explanations on the course of the disease and not prescribe antibiotics.