This article reports the results of a randomized, controlled trial of cotrimoxazole vs. placebo in 84 children with measles in Guinea-Bissau. The trial was conducted in 1998 (why are the results coming only 8 years later?). Results? "One of 46 participants who received co-trimoxazole developed pneumonia, in contrast to six of 38 participants who received placebo (odds ratio 0.08 (95% confidence interval 0 to 0.56), adjusted for age group)."

Furthermore, the group receiving cotrimoxazole had less conjunctivitis and greater weight gain, and not-statistically-significant decreases in other complications.

Given the small sample size, the power to detect reduction in less frequent events such as death, or to detect small reductions, is limited. But the positive results of this first randomized, controlled trial are impressive. They are not conclusive and they certainly call for similar studies to be repeated in other settings, perhaps with a different antibiotic, and larger numbers of children.

Prophylactic antibiotics to prevent pneumonia and other complications after measles: community based randomised double blind placebo controlled trial in Guinea-Bissau. BMJ 2006;333:1245 (16 December). Free full access.

Keywords : measles; antibiotic; cotrimoxazole; septrin; pneumonia; complications; child survival; Africa

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