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http://repositorio.pediatria.gob.mx:8180/handle/20.500.12103/2658| Título : | Oral amoxicillin versus injectable penicillin for severe pneumonia in children aged 3 to 59 months: a randomised multicentre equivalency study |
| Creador: | Addo Yobo, Emmanuel |
| Nivel de acceso: | Open access |
| Palabras clave : | Amoxicilina - administración y dosificación Antimicrobianos - administración y dosificación Infecciones por Haemophilus - diagnóstico Amoxicillin - administration & dosage Anti-Bacterial Agents - administration & dosage Haemophilus Infections - Diagnosis |
| Descripción : | Background Injectable penicillin is the recommended treatment for WHO-defined severe pneumonia (lower chest indrawing). If oral amoxicillin proves equally effective, it could reduce referral, admission, and treatment costs. We aimed to determine whether oral amoxicillin and parenteral penicillin were equivalent in the treatment of severe pneumonia in children aged 3–59 months. Methods This multicentre, randomised, open-label equivalency study was undertaken at tertiary-care centres in eight developing countries in Africa, Asia, and South America. Children aged 3–59 months with severe pneumonia were admitted for 48 h and, if symptoms improved, were discharged with a 5-day course of oral amoxicillin. 1702 children were randomly allocated to receive either oral amoxicillin (n=857) or parenteral penicillin (n=845) for 48 h. Follow-up assessments were done at 5 and 14 days after enrolment. Primary outcome was treatment failure (persistence of lower chest indrawing or new danger signs) at 48 h. Analyses were by intention-to-treat and per protocol. Findings Treatment failure was 19% in each group (161 patients, pencillin; 167 amoxillin; risk difference –0·4%; 95% CI –4·2 to 3·3) at 48 h. Infancy (age 3–11 months; odds ratio 2·72, 95% CI 1·95 to 3·79), very fast breathing (1·94, 1·42 to 2·65), and hypoxia (1·95, 1·34 to 2·82) at baseline predicted treatment failure by multivariate analysis. Interpretation Injectable penicillin and oral amoxicillin are equivalent for severe pneumonia treatment in controlled settings. Potential benefits of oral treatment include decreases in (1) risk of needle-borne infections; (2) need for referral or admission; (3) administration costs; and (4) costs to the family. |
| Colaborador(es) u otros Autores: | Chisaka Noel Hassan Mumtaz Hibberd Patricia Lozano Juan M Jeena Prakash MacLeod William B Maulen Irene Patel Archana Qazi Shamim Thea Donald M Ngoc Tuong Vy Nguyen Amoxicillin Penicillin Pneumonia International Study (APPIS) |
| Fecha de publicación : | 2004 |
| Tipo de publicación: | Artículo |
| Formato: | |
| Identificador del Recurso : | 10.1016/S0140-6736(04)17100-6 |
| Fuente: | Lancet 364(9440):1141-1148 |
| URI : | http://repositorio.pediatria.gob.mx:8180/handle/20.500.12103/2658 |
| Idioma: | eng |
| Aparece en las colecciones: | Artículos |
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