Recent international trials involving over 12,000 infants, including more than 2,000 in Pakistan, indicate that treating newborns with signs of severe bacterial infection at home or in nearby clinics can be as safe and effective as hospital care — and significantly cheaper.

The findings were presented at a seminar hosted by the Department of Paediatrics and Child Health at Aga Khan University in Karachi, highlighting the potential for lifesaving care to reach families who face barriers to hospital treatment.

Sepsis and serious infections are prevalent among infants under 59 days old, with symptoms such as fever, rapid breathing, chest indrawing, poor feeding, low body temperature, and lethargy, collectively termed Possible Serious Bacterial Infection (PSBI). Many parents in Pakistan avoid hospital visits due to financial, logistical, or cultural obstacles.

Dr. Salim Virani emphasized the importance of practical healthcare solutions, stating, “We know that we can take care of most of the illnesses of the world with what we know already.”

The trials, supported by the World Health Organization, evaluated outpatient or home-based treatment as a viable alternative for low- to moderate-risk infants. Conducted at four major pediatric centers in Karachi, the studies involved 1,125 infants in trial 1 and 799 in trial 2.

Participants were treated with simplified antibiotic regimens, with the first trial focusing on infants with single low-risk symptoms and the second on those with multiple mild symptoms or one moderately concerning sign.

Results showed no significant difference in outcomes between infants treated at hospitals and those receiving home or nearby clinic care. Most infants adhered to treatment protocols, with 95% completing the prescribed outpatient course of gentamicin injections and oral amoxicillin. Severe side effects were rare, and mortality rates were equal to or lower in the home-care groups.

The research underscores the potential for safe and sustainable home-based care, especially in low-resource or rural areas of Pakistan. By implementing simplified outpatient PSBI management, healthcare systems could significantly improve newborn survival rates and strengthen primary care infrastructure.

These findings also hold global relevance, offering a roadmap for expanding access to lifesaving care in countries where hospitalization is not always an option.