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Outcome of children hospitalized with community-acquired pneumonia treated with aqueous penicillin G.

Simbalista R, Araújo M, Nascimento-Carvalho CM - Clinics (Sao Paulo) (2011)

Bottom Line: Confounders leading to exclusion included underlying debilitating or chronic pulmonary illnesses, nosocomial pneumonia or transference to another hospital.Penicilli was substituted by other antibiotics in 28 (18%) patients, in whom the sole significant decrease was in the frequency of tachypnea from the first to the second day of treatment (86% vs. 50%, p = 0.008).Penicillin G successfully treated 82% (126/154) of the study group and improvement was marked on the first day of treatment.

View Article: PubMed Central - PubMed

Affiliation: School of Medicine, Federal University of Bahia, Salvador, Brazil.

ABSTRACT

Objective: To describe the evolution and outcome of children hospitalized with community-acquired pneumonia receiving penicillin.

Methods: A search was carried out for all hospitalized community-acquired pneumonia cases in a 37-month period. Inclusion criteria comprised age >2 months, intravenous penicillin G use at 200,000 IU/kg/day for >48 h and chest x-ray results. Confounders leading to exclusion included underlying debilitating or chronic pulmonary illnesses, nosocomial pneumonia or transference to another hospital. Pneumonia was confirmed if a pulmonary infiltrate or pleural effusion was described by an independent radiologist blind to the clinical information. Data on admission and evolution were entered on a standardized form.

Results: Of 154 studied cases, 123 (80%) and 40 (26%) had pulmonary infiltrate or pleural effusion, respectively. Penicilli was substituted by other antibiotics in 28 (18%) patients, in whom the sole significant decrease was in the frequency of tachypnea from the first to the second day of treatment (86% vs. 50%, p = 0.008). Among patients treated exclusively with penicillin G, fever (46% vs. 26%, p = 0.002), tachypnea (74% vs. 59%, p = 0.003), chest indrawing (29% vs. 13%, p<0.001) and nasal flaring (10% vs. 1.6%, p = 0.001) frequencies significantly decreased from admission to the first day of treatment. Patients treated with other antimicrobial agents stayed longer in the hospital than those treated solely with penicillin G (16 ± 6 vs. 8 ± 4 days, p<0.001, mean difference (95% confidence interval) 8 (6-10)). None of the studied patients died.

Conclusion: Penicillin G successfully treated 82% (126/154) of the study group and improvement was marked on the first day of treatment.

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Related in: MedlinePlus

Daily evolution (%) of (A) 126 children hospitalized with community‐acquired pneumonia treated exclusively with penicillin G and (B) 28 children hospitalized with community‐acquired pneumonia in whom penicillin G was substituted by other antimicrobial agents after 2 days of us.
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f2-cln_66p95: Daily evolution (%) of (A) 126 children hospitalized with community‐acquired pneumonia treated exclusively with penicillin G and (B) 28 children hospitalized with community‐acquired pneumonia in whom penicillin G was substituted by other antimicrobial agents after 2 days of us.

Mentions: Comparison of the daily frequency of clinical findings in this group showed that the only significant difference was tachypnea from the first to second day of treatment (86.4% vs. 50.0%, p = 0.008). Among patients receiving only penicillin G during the whole treatment, significant differences were found between admission and first day of treatment: fever (46.4% vs. 26.3%, p = 0.002), tachypnea (73.6% vs. 59.4%, p = 0.003), chest indrawing (29.4% vs. 12.7%, p<0.001) and nasal flaring (10.2% vs. 1.6%, p = 0.001). Differences were also found in the frequency of fever between the second and third day (26.8% vs. 13.7%, p = 0.001) and between the fourth and fifth day (17.8% vs. 10.3%, p = 0.006). Figures 2A and 2B present the daily evolution of clinical findings in the groups of patients without and with penicillin G substitution after 48 h of treatment. Antibiotic change was not associated with pleural effusion (25.0% vs. 15.8%, p = 0.2), severe (19.6% vs. 17.6%, p = 0.8) or very severe (15.8% vs. 18.5%, p = 1) CAP according to WHO, severe CAP according to BTS (18.7% vs. 17.0%, p = 0.8), severe malnutrition (16.7% vs. 18.2%, p = 1) or age (38±29 vs. 30±24 months, p = 0.2).


Outcome of children hospitalized with community-acquired pneumonia treated with aqueous penicillin G.

Simbalista R, Araújo M, Nascimento-Carvalho CM - Clinics (Sao Paulo) (2011)

Daily evolution (%) of (A) 126 children hospitalized with community‐acquired pneumonia treated exclusively with penicillin G and (B) 28 children hospitalized with community‐acquired pneumonia in whom penicillin G was substituted by other antimicrobial agents after 2 days of us.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3044566&req=5

f2-cln_66p95: Daily evolution (%) of (A) 126 children hospitalized with community‐acquired pneumonia treated exclusively with penicillin G and (B) 28 children hospitalized with community‐acquired pneumonia in whom penicillin G was substituted by other antimicrobial agents after 2 days of us.
Mentions: Comparison of the daily frequency of clinical findings in this group showed that the only significant difference was tachypnea from the first to second day of treatment (86.4% vs. 50.0%, p = 0.008). Among patients receiving only penicillin G during the whole treatment, significant differences were found between admission and first day of treatment: fever (46.4% vs. 26.3%, p = 0.002), tachypnea (73.6% vs. 59.4%, p = 0.003), chest indrawing (29.4% vs. 12.7%, p<0.001) and nasal flaring (10.2% vs. 1.6%, p = 0.001). Differences were also found in the frequency of fever between the second and third day (26.8% vs. 13.7%, p = 0.001) and between the fourth and fifth day (17.8% vs. 10.3%, p = 0.006). Figures 2A and 2B present the daily evolution of clinical findings in the groups of patients without and with penicillin G substitution after 48 h of treatment. Antibiotic change was not associated with pleural effusion (25.0% vs. 15.8%, p = 0.2), severe (19.6% vs. 17.6%, p = 0.8) or very severe (15.8% vs. 18.5%, p = 1) CAP according to WHO, severe CAP according to BTS (18.7% vs. 17.0%, p = 0.8), severe malnutrition (16.7% vs. 18.2%, p = 1) or age (38±29 vs. 30±24 months, p = 0.2).

Bottom Line: Confounders leading to exclusion included underlying debilitating or chronic pulmonary illnesses, nosocomial pneumonia or transference to another hospital.Penicilli was substituted by other antibiotics in 28 (18%) patients, in whom the sole significant decrease was in the frequency of tachypnea from the first to the second day of treatment (86% vs. 50%, p = 0.008).Penicillin G successfully treated 82% (126/154) of the study group and improvement was marked on the first day of treatment.

View Article: PubMed Central - PubMed

Affiliation: School of Medicine, Federal University of Bahia, Salvador, Brazil.

ABSTRACT

Objective: To describe the evolution and outcome of children hospitalized with community-acquired pneumonia receiving penicillin.

Methods: A search was carried out for all hospitalized community-acquired pneumonia cases in a 37-month period. Inclusion criteria comprised age >2 months, intravenous penicillin G use at 200,000 IU/kg/day for >48 h and chest x-ray results. Confounders leading to exclusion included underlying debilitating or chronic pulmonary illnesses, nosocomial pneumonia or transference to another hospital. Pneumonia was confirmed if a pulmonary infiltrate or pleural effusion was described by an independent radiologist blind to the clinical information. Data on admission and evolution were entered on a standardized form.

Results: Of 154 studied cases, 123 (80%) and 40 (26%) had pulmonary infiltrate or pleural effusion, respectively. Penicilli was substituted by other antibiotics in 28 (18%) patients, in whom the sole significant decrease was in the frequency of tachypnea from the first to the second day of treatment (86% vs. 50%, p = 0.008). Among patients treated exclusively with penicillin G, fever (46% vs. 26%, p = 0.002), tachypnea (74% vs. 59%, p = 0.003), chest indrawing (29% vs. 13%, p<0.001) and nasal flaring (10% vs. 1.6%, p = 0.001) frequencies significantly decreased from admission to the first day of treatment. Patients treated with other antimicrobial agents stayed longer in the hospital than those treated solely with penicillin G (16 ± 6 vs. 8 ± 4 days, p<0.001, mean difference (95% confidence interval) 8 (6-10)). None of the studied patients died.

Conclusion: Penicillin G successfully treated 82% (126/154) of the study group and improvement was marked on the first day of treatment.

Show MeSH
Related in: MedlinePlus