Penicillin and gentamicin therapy vs amoxicillin/clavulanate in severe hypoxemic pneumonia.

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dc.contributor.authorBansal, Arunen_US
dc.contributor.authorSinghi, Sunit Cen_US
dc.contributor.authorJayashree, Men_US
dc.date.accessioned2006-04-04en_US
dc.date.accessioned2009-05-30T11:44:55Z
dc.date.available2006-04-04en_US
dc.date.available2009-05-30T11:44:55Z
dc.date.issued2006-04-04en_US
dc.description.abstractOBJECTIVE: 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.en_US
dc.description.affiliationDepartment of Pediatrics, Advanced Pediatrics Center, Post Graduate Institute of Medical Education and Research Center, Chandigarh, India.en_US
dc.identifier.citationBansal A, Singhi SC, Jayashree M. Penicillin and gentamicin therapy vs amoxicillin/clavulanate in severe hypoxemic pneumonia. Indian Journal of Pediatrics. 2006 Apr; 73(4): 305-9en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/79990
dc.language.isoengen_US
dc.source.urihttps://medind.nic.in/icb/icbai.shtmlen_US
dc.subject.meshAdministration, Oralen_US
dc.subject.meshAmoxicillin --administration & dosageen_US
dc.subject.meshAmoxicillin-Potassium Clavulanate Combination --therapeutic useen_US
dc.subject.meshAnti-Bacterial Agents --therapeutic useen_US
dc.subject.meshChild, Preschoolen_US
dc.subject.meshDrug Therapy, Combinationen_US
dc.subject.meshFemaleen_US
dc.subject.meshGentamicins --therapeutic useen_US
dc.subject.meshHaemophilus Infections --drug therapyen_US
dc.subject.meshHaemophilus influenzaeen_US
dc.subject.meshHumansen_US
dc.subject.meshInfanten_US
dc.subject.meshInfusions, Intravenousen_US
dc.subject.meshMaleen_US
dc.subject.meshPenicillins --therapeutic useen_US
dc.subject.meshPneumonia, Bacterial --drug therapyen_US
dc.subject.meshPneumonia, Pneumococcal --drug therapyen_US
dc.subject.meshTreatment Outcomeen_US
dc.titlePenicillin and gentamicin therapy vs amoxicillin/clavulanate in severe hypoxemic pneumonia.en_US
dc.typeComparative Studyen_US
dc.typeJournal Articleen_US
dc.typeRandomized Controlled Trialen_US
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