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. 2011;66(1):95-100.
doi: 10.1590/s1807-59322011000100017.

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

Raquel Simbalista  1 , Marcelo Araújo, Cristiana M Nascimento-Carvalho
Affiliations

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

Raquel Simbalista et al. Clinics (Sao Paulo). 2011.

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.

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Figures

Figure 1
Figure 1
Flow chart of the study group enrollment for the community‐acquired pneumonia retrospective longitudinal study in Salvador, Northeast Brazi. CAP, community‐acquired pneumonia; CXR, chest x‐ray.
Figure 2A
Figure 2A
Daily evolution (%) of (A) 126 children hospitalized with community‐acquired pneumonia treated exclusively with penicillin G and (B) 28 children hospitalized with community‐acquired pneumonia in whom penicillin G was substituted by other antimicrobial agents after 2 days of us.
See this image and copyright information in PMC

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