Penicillin and gentamicin therapy vs amoxicillin/clavulanate in severe hypoxemic pneumonia.
Indian J Pediatr
;
2006 Apr; 73(4): 305-9
Article
Dans Anglais
| IMSEAR
| ID: sea-79990
ABSTRACT
OBJECTIVE:
To compare the efficacy of sequential injectable crystalline penicillin (C.pen) and gentamicin combination followed by oral amoxicillin with sequential IV and oral amoxicillin-clavulanate (amox-clav) in treatment of severe or very severe hypoxemic pneumonia.METHODS:
Children aged 2-59 months with WHO-defined severe or very severe pneumonia with hypoxemia (SpO2 < 90%) were included in the study. Patients with fever > 10 days, bacterial meningitis, prior antibiotic therapy > 24 hours, stridor, heart disease and allergy to any of the study drugs were excluded. They were randomly allocated to two groups--Group A and Group B. Group A received C. pen and gentamicin intravenously (IV), followed by oral amoxicillin and group B got amox-clav IV, followed by oral amox-clav. Minimum duration of IV therapy was 3 days and total 7 days. Respiratory rate, oxygen saturation and chest wall indrawing were monitored 6 hourly.RESULTS:
71 patients were included. There were two (5.2%) blood cultures positive in group A and three (9%) in group B. Organisms isolated were S. pneumoniae (n=3) and H. influenzae-b (n=2). There was only one treatment failure in each of the groups. One was due to penicillin resistant H. influenzae -b and the other was due to worsening of pneumonia. The mean time taken for normalization of tachypnea, hypoxia, chest wall indrawing and inability to feed was similar (P-N.S). Mean duration of IV therapy in group A was 76+/-25 hrs and group B was 75+/-24 hrs (p>0.1).CONCLUSION:
In children of 2-59 months, sequential injectable C. pen and gentamicin combination, followed by oral amoxicillin or sequential IV and oral amox-clav were equally effective for the treatment of severe or very severe hypoxemic community acquired pneumonia.
Texte intégral:
Disponible
Indice:
IMSEAR (Asie du Sud-Est)
Sujet Principal:
Pénicillines
/
Pneumonie à pneumocoques
/
Perfusions veineuses
/
Femelle
/
Humains
/
Mâle
/
Gentamicine
/
Enfant d'âge préscolaire
/
Haemophilus influenzae
/
Administration par voie orale
Type d'étude:
Essai clinique contrôlé
langue:
Anglais
Texte intégral:
Indian J Pediatr
Année:
2006
Type:
Article
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