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

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.

Community-acquired pneumonia among children: the latest evidence for an updated management

“…Entre os 128 casos restantes que receberam penicilina G durante todo o período de tratamento, taquipneia, febre e retração torácica ainda estavam presentes após 48 horas de antibioticoterapia em 51,0%, 26,8% e 10,3% dos casos, respectivamente; de maneira similar, 120 horas após o início do tratamento, em 33,3%, 10,3% e 2,2% dos casos, respectivamente. 65 Notavelmente, todos os pacientes tiveram recuperação completa e receberam alta hospitalar com amoxicilina oral em substituição à penicilina G aquosa para o término da terapia antimicrobiana. Esses números mostram que os pacientes podem ter uma recuperação lenta, sugerem que não há necessidade de substituição de antibióticos se o paciente não apresentar deterioração clínica/radiológica.…”

Outcome of children with community acquired pneumonia treated with injection crystalline penicillin a prospective study

“…The combination of tachypnea, tachycardia, fever, and localized findings (rales or wheezing) both before and after bronchodilator therapy identified pneumonia in 95% of children >1 year of age with the first episode of wheezing [9]. Similarly, the most common presenting complaints of pneumonia were cough (99.2%), fever (97.2%) and difficulty in breathing (56.5%) in a study done in 154 hospitalized children aged more than two months with CAP, the examination findings were tachypnea (75.2%), fever (49.7%) and crackles (33.8%) [10].…”

Crystalline Penicillin for Community Acquired Pneumonia: Does it still work?

“…15 Another study done in Finland showed that out of 153 children hospitalized for uncomplicated CAP, 66% were treated with penicillin G and they also showed a rapid and uneventful recovery. 17 Penicillin G is still considered a drug of choice in hospitalized children with CAP even in many European countries with low penicillin resistance of pneumococci.…”

“…e ndings were tachypnea (75.2%), fever (49.7%) and crackles (33.8%). 15 All these show that fever, cough and tachypnoea can be used as the diagnostic tool for pneumonia where chest X-ray is not always possible especially in rural and under equipped health settings.…”