Antibiotic treatment schemes for very severe community-acquired pneumonia in children: A randomized clinical study

Detalhes bibliográficos
Autor(a) principal: Ribeiro, Cristiane Franco [UNESP]
Data de Publicação: 2011
Outros Autores: Ferrari, Giesela Fleisher [UNESP], Fioretto, José Roberto [UNESP]
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da UNESP
Texto Completo: http://hdl.handle.net/11449/226465
Resumo: Objective. To compare clinical response to initial empiric treatment with oxacillin plus ceftriaxone and amoxicillin plus clavulanic acid in hospitalized children diagnosed with very severe community-acquired pneumonia (CAP). Methods. A prospective randomized clinical study was conducted among children 2 months to 5 years old with a diagnosis of very severe CAP in the pediatric ward of São Paulo State University Hospital in Botucatu, São Paulo, Brazil, from April 2007 to May 2008. Patients were randomly divided into two groups by type of treatment: an oxacillin/ceftriaxone group (OCG, n = 48) and an amoxicillin/clavulanic acid group (ACG, n = 56). Analyzed outcomes were: time to clinical improvement (fever and tachypnea), time on oxygen therapy, length of stay in hospital, need to widen antimicrobial spectrum, and complications (including pleural effusion). Results. The two groups did not differ statistically for age, sex, symptom duration before admission, or previous antibiotic treatment. Time to improve tachypnea was less among ACG patients than OCG patients (4.8 ± 2.2 versus 5.8 ± 2.4 days respectively; P = 0.028), as was length of hospital stay (11.0 ± 6.2 versus 14.4 ± 4.5 days respectively; P = 0.002). There were no statistically significant differences between the two groups for fever improvement time, time on oxygen therapy, need to widen antimicrobial spectrum, or frequency of pleural effusion. Conclusions. Both treatment plans are effective in treating very severe CAP in 2-monthto 5-year-old hospitalized children. The only analyzed outcome that favored amoxicillin/ clavulanic acid treatment was time required to improve tachypnea.
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spelling Antibiotic treatment schemes for very severe community-acquired pneumonia in children: A randomized clinical studyAmoxicillinAnti-bacterial agentsBrazilCeftriaxoneChild, preschoolClavulanic acidInfantOxacillinPneumoniaRandomized clinical trialObjective. To compare clinical response to initial empiric treatment with oxacillin plus ceftriaxone and amoxicillin plus clavulanic acid in hospitalized children diagnosed with very severe community-acquired pneumonia (CAP). Methods. A prospective randomized clinical study was conducted among children 2 months to 5 years old with a diagnosis of very severe CAP in the pediatric ward of São Paulo State University Hospital in Botucatu, São Paulo, Brazil, from April 2007 to May 2008. Patients were randomly divided into two groups by type of treatment: an oxacillin/ceftriaxone group (OCG, n = 48) and an amoxicillin/clavulanic acid group (ACG, n = 56). Analyzed outcomes were: time to clinical improvement (fever and tachypnea), time on oxygen therapy, length of stay in hospital, need to widen antimicrobial spectrum, and complications (including pleural effusion). Results. The two groups did not differ statistically for age, sex, symptom duration before admission, or previous antibiotic treatment. Time to improve tachypnea was less among ACG patients than OCG patients (4.8 ± 2.2 versus 5.8 ± 2.4 days respectively; P = 0.028), as was length of hospital stay (11.0 ± 6.2 versus 14.4 ± 4.5 days respectively; P = 0.002). There were no statistically significant differences between the two groups for fever improvement time, time on oxygen therapy, need to widen antimicrobial spectrum, or frequency of pleural effusion. Conclusions. Both treatment plans are effective in treating very severe CAP in 2-monthto 5-year-old hospitalized children. The only analyzed outcome that favored amoxicillin/ clavulanic acid treatment was time required to improve tachypnea.Departamento de Pediatria Faculdade de Medicina de Botucatu Universidade Estadual Paulista, Botucatu, SPDepartamento de Pediatria Faculdade de Medicina de Botucatu Universidade Estadual Paulista, Botucatu, SPUniversidade Estadual Paulista (UNESP)Ribeiro, Cristiane Franco [UNESP]Ferrari, Giesela Fleisher [UNESP]Fioretto, José Roberto [UNESP]2022-04-29T00:12:34Z2022-04-29T00:12:34Z2011-06-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article444-450Revista Panamericana de Salud Publica/Pan American Journal of Public Health, v. 29, n. 6, p. 444-450, 2011.1020-49891680-5348http://hdl.handle.net/11449/2264652-s2.0-80051538377Scopusreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengRevista Panamericana de Salud Publica/Pan American Journal of Public Healthinfo:eu-repo/semantics/openAccess2024-09-03T13:46:21Zoai:repositorio.unesp.br:11449/226465Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestrepositoriounesp@unesp.bropendoar:29462024-09-03T13:46:21Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false
dc.title.none.fl_str_mv Antibiotic treatment schemes for very severe community-acquired pneumonia in children: A randomized clinical study
title Antibiotic treatment schemes for very severe community-acquired pneumonia in children: A randomized clinical study
spellingShingle Antibiotic treatment schemes for very severe community-acquired pneumonia in children: A randomized clinical study
Ribeiro, Cristiane Franco [UNESP]
Amoxicillin
Anti-bacterial agents
Brazil
Ceftriaxone
Child, preschool
Clavulanic acid
Infant
Oxacillin
Pneumonia
Randomized clinical trial
title_short Antibiotic treatment schemes for very severe community-acquired pneumonia in children: A randomized clinical study
title_full Antibiotic treatment schemes for very severe community-acquired pneumonia in children: A randomized clinical study
title_fullStr Antibiotic treatment schemes for very severe community-acquired pneumonia in children: A randomized clinical study
title_full_unstemmed Antibiotic treatment schemes for very severe community-acquired pneumonia in children: A randomized clinical study
title_sort Antibiotic treatment schemes for very severe community-acquired pneumonia in children: A randomized clinical study
author Ribeiro, Cristiane Franco [UNESP]
author_facet Ribeiro, Cristiane Franco [UNESP]
Ferrari, Giesela Fleisher [UNESP]
Fioretto, José Roberto [UNESP]
author_role author
author2 Ferrari, Giesela Fleisher [UNESP]
Fioretto, José Roberto [UNESP]
author2_role author
author
dc.contributor.none.fl_str_mv Universidade Estadual Paulista (UNESP)
dc.contributor.author.fl_str_mv Ribeiro, Cristiane Franco [UNESP]
Ferrari, Giesela Fleisher [UNESP]
Fioretto, José Roberto [UNESP]
dc.subject.por.fl_str_mv Amoxicillin
Anti-bacterial agents
Brazil
Ceftriaxone
Child, preschool
Clavulanic acid
Infant
Oxacillin
Pneumonia
Randomized clinical trial
topic Amoxicillin
Anti-bacterial agents
Brazil
Ceftriaxone
Child, preschool
Clavulanic acid
Infant
Oxacillin
Pneumonia
Randomized clinical trial
description Objective. To compare clinical response to initial empiric treatment with oxacillin plus ceftriaxone and amoxicillin plus clavulanic acid in hospitalized children diagnosed with very severe community-acquired pneumonia (CAP). Methods. A prospective randomized clinical study was conducted among children 2 months to 5 years old with a diagnosis of very severe CAP in the pediatric ward of São Paulo State University Hospital in Botucatu, São Paulo, Brazil, from April 2007 to May 2008. Patients were randomly divided into two groups by type of treatment: an oxacillin/ceftriaxone group (OCG, n = 48) and an amoxicillin/clavulanic acid group (ACG, n = 56). Analyzed outcomes were: time to clinical improvement (fever and tachypnea), time on oxygen therapy, length of stay in hospital, need to widen antimicrobial spectrum, and complications (including pleural effusion). Results. The two groups did not differ statistically for age, sex, symptom duration before admission, or previous antibiotic treatment. Time to improve tachypnea was less among ACG patients than OCG patients (4.8 ± 2.2 versus 5.8 ± 2.4 days respectively; P = 0.028), as was length of hospital stay (11.0 ± 6.2 versus 14.4 ± 4.5 days respectively; P = 0.002). There were no statistically significant differences between the two groups for fever improvement time, time on oxygen therapy, need to widen antimicrobial spectrum, or frequency of pleural effusion. Conclusions. Both treatment plans are effective in treating very severe CAP in 2-monthto 5-year-old hospitalized children. The only analyzed outcome that favored amoxicillin/ clavulanic acid treatment was time required to improve tachypnea.
publishDate 2011
dc.date.none.fl_str_mv 2011-06-01
2022-04-29T00:12:34Z
2022-04-29T00:12:34Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv Revista Panamericana de Salud Publica/Pan American Journal of Public Health, v. 29, n. 6, p. 444-450, 2011.
1020-4989
1680-5348
http://hdl.handle.net/11449/226465
2-s2.0-80051538377
identifier_str_mv Revista Panamericana de Salud Publica/Pan American Journal of Public Health, v. 29, n. 6, p. 444-450, 2011.
1020-4989
1680-5348
2-s2.0-80051538377
url http://hdl.handle.net/11449/226465
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv Revista Panamericana de Salud Publica/Pan American Journal of Public Health
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 444-450
dc.source.none.fl_str_mv Scopus
reponame:Repositório Institucional da UNESP
instname:Universidade Estadual Paulista (UNESP)
instacron:UNESP
instname_str Universidade Estadual Paulista (UNESP)
instacron_str UNESP
institution UNESP
reponame_str Repositório Institucional da UNESP
collection Repositório Institucional da UNESP
repository.name.fl_str_mv Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)
repository.mail.fl_str_mv repositoriounesp@unesp.br
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