Predicting fever response of children with pneumonia treated with antibiotics

Abstract

In order to study predictors of fever response in children with radiologic pulmonary infiltrates treated with antibiotics, 156 children with pneumonia were evaluated with slide test C-reactive protein (CRP), white blood cell count (WBC), erythrocyte sedimentation rate (ESR), blood cultures, acute and convalescent viral and mycoplasma titers, and then followed clinically. Both CRP (+) at a serum dilution of 1:50 and WBC greater than or equal to 15,000 were better predictors of rapid resolution of fever while the patient was receiving antibiotics than were ESR greater than or equal to 30 or temperature greater than or equal to 40 C. WBC greater than or equal to 15,000 was nearly as specific but more sensitive than CRP (+) 1:50 for resolution of fever in either 8, 12 or 24 hours. Positive blood or lung bacterial cultures, but not four-fold or greater viral or mycoplasma titer increases, were also associated with rapid resolution of fever. WBC greater than or equal to 15,000 is useful in predicting rapid fever response in children with pneumonia treated with antibiotics.