Antibiotic treatment of children with community-acquired pneumonia: Comparison of penicillin or ampicillin versus cefuroxime

Dinur–Schejter Y et al. – In previously healthy children, parenteral penicillin or ampicillin for treatment of non–complicated community–acquired pneumonia (CAP) in–hospital is as effective as cefuroxime, and should remain the recommended first–line therapy.

Methods

• All children aged 3 months to 2 years with non-complicated CAP treated with penicillin or ampicillin or cefuroxime, admitted during 2003-2008, in the Departments of Pediatrics, Hadassah University Medical Center were included.
• Presenting signs, symptoms, laboratory findings at presentation, clinical parameters including number of days with IV antibiotics, oxygen treatment, length of hospital stay, change of antibiotics, and clinical course 72hr and 1week after admission, were compared.

Results

• Of the 319 children admitted for non-complicated CAP, 66 were treated with IV penicillin or ampicillin, 253 with IV cefuroxime.
• Number of days of IV treatment, days of oxygen requirement, and days of hospitalization were similar (2.36±1.6days vs. 2.59±1.6days, 0.31±1.2days vs. 0.64±1.3days, and 2.67±1.4days vs. 2.96±1.7days, respectively).
• Treatment failure was not significantly different (7.6% vs. 4.7%).
• The number of patients who were febrile or required oxygen 72hr after admission was similar (13.0% vs. 16.5% and 8.7% vs. 20.9%, respectively).
• One week after admission no difference between the two groups was seen.

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