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May 9, 1977

Why Now? Use of Tetracycline in Young Children

JAMA. 1977;237(19):2101. doi:10.1001/jama.1977.03270460087031

Tetracyclines are not effective against viruses, which cause 90% of upper and 50% of lower respiratory tract infections in children, nor are they the drugs of choice for the four bacteria that cause pneumonia in children.1,2 Provided there is no malnutrition or underlying disease, the usual causes of bacterial respiratory infections in young children are Diplococcus pneumoniae, Streptococcus pyogenes, Haemophilus influenzae, or Staphylococcus aureus. While the toxicity of the tetracyclines in young children is not to be discounted, a more important argument against their use is that they are not the most effective drugs available against these bacteria. What remaining activity the tetracyclines have against the Enterobacteriaceae is of no benefit to the normal child afflicted with a respiratory infection. Organisms such as Escherichia coli are almost never the cause of the problem.

Ray, Federspiel, and Schaffner report elsewhere in this issue (p 2069) that 80% of the children