Treatment of presumed bacterial pneumonia in ambulatory children.
In a prospective, randomized, open study, a combination of trimethoprim and rifampin (TMP/R) 20 mg/kg/day was compared with ampicillin (AMP) 150 mg/kg/day, both given orally twice daily for 10 days, for the treatment of 60 children who had mild community-acquired pneumonia. The control group comprised 112 healthy children. The overall duration of the disease was 8.5 +/- 3.6 days in the TMP/R group vs 6.0 +/- 1.1 days in the AMP group. Fever persisted for 7.0 +/- 1.8 days in the TMP/R-treated patients vs 5.2 +/- 1.0 days in the AMP-treated patients. At the end of the 10 days, nasopharyngeal cultures were negative in all patients in the AMP group and in 25 of the 30 patients in the TMP/R group. These five patients were clinical and microbiologic failures. We conclude that in infants and children with mild community-acquired pneumonia, treatment with AMP for 10 days is more effective than treatment with a combination of TMP/R for clinical cure and eradication of bacterial pathogens.
Calderon
E
E
Center for Research on Infectious Diseases, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
Gatica
R
R
Echániz
G
G
Conde
C
C
Salinas
L
L
Olvera
G
G
Zorrilla
E
E
Velazquez
M E
ME
D000667:Ampicillin / Q000009:adverse effects / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D006193:Haemophilus influenzae / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D001936:Moraxella catarrhalis / Q000302:isolation & purification; D009305:Nasopharynx / Q000382:microbiology; D010033:Otitis Media / Q000188:drug therapy / Q000382:microbiology; D011014:Pneumonia / Q000188:drug therapy* / Q000382:microbiology; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000188:drug therapy* / Q000382:microbiology; D012293:Rifampin / Q000009:adverse effects / Q000627:therapeutic use; D013296:Streptococcus pneumoniae / Q000302:isolation & purification; D014295:Trimethoprim / Q000009:adverse effects / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D000667:Ampicillin; D014295:Trimethoprim; D012293:Rifampin