The efficacy of ampicillin vs. cephalosporins in the treatment of community adquire pneumonia in inpatient children hospital III Grau

Abstract

Introduction: Community adquire pneumonia (CAP) is one of the most serious diseases in the childhood. It is necessary to choose the correct antibiotic. Bacterial resistance complicates the therapy and makes it necessary to use new antibiotics; so young doctors have poor experience to use penicillin. Objective: To compare clinical effectiveness of ampicillin to 1st and 3rd generation cephalosporin in the treatment of community adquire pneumonia in inpatient children. Patients and methods: Descriptive retrospective study, included children inpatient in Emergencias Grau Hospital III Essalud Lima Perú, from 2 months to 5 years old, from July 2013 to July 2014. Clinical variables of antibiotic groups were compared. Effectiveness was analyzed with Kaplan Meier curves-Log Rank method. Survival to treatment was determined by time between starting and change of antibiotic. Results: 149 children were included, 50% were under one year old, 87% were diagnosed as bronchopneumonia and acute bronchial obstructive syndrome (ABOS) and 11% CAP. Antibiotics: ampicillin 52%, cefazolin 25%, ceftriaxone 16% and claritromycin 4%. Statistically significant results favored ampicillin: more indicated in under one year old (p=0, 01), respiratory distress shorter (p=0,006) and recovering faster (p=0, 01). There was no significant difference at comparing the need for antibiotic change when using ampicillin, cefazolin and ceftriaxone. It did show difference when compared to other antibiotics (p=0,012). Conclusion: ampicillin is as effective as cefazolin or ceftriaxone for the treatment of CAP in children. It is suggested to follow the antibiotic ladder, to rationalize antibiotics and to avoid bacterial resistance.