Comparative efficacy of amoxicillin, cefuroxime and clarithromycin in the treatment of community -acquired pneumonia in children.
OBJECTIVE
To compare the clinical response to amoxicillin, cefuroxime and clarithromycin in the treatment of community-acquired pneumonia in children and to see the cost effectiveness of each treatment.


METHODS
Randomized clinical control trial.


METHODS
Department of Pediatrics, Khyber teaching hospital, Peshawar, from October 2001 to February 2002.


METHODS
Patients between 3 to 72 months of age, admitted in the hospital with community acquired pneumonia, were randomly divided into three groups,1,2,3. They were started on amoxicillin, cefuroxime and clarithromycin respectively. The patients were assessed daily. If there was no clinical improvement at 48 hours the antibiotic was changed. ANOVA statistical test was applied to see the clinical response to the treatment in the three groups. Cost effectiveness of the treatment was compared.


RESULTS
There was no statistical difference in the clinical response at 48 hours of initiating treatment and at discharge (p > 0.01 each). The mean hospital stay in group 1 and 2 was 3.3 days and group 3 was 3.2 days respectively (p > 0.01). Ninety-seven percent patients in group 1 and 3, and 95% patients in group 2 showed clinical improvement. The cost of treatment of community acquired pneumonia for 8 days was Rs 496/-, 730/-, 1018/- for amoxicillin, clarithromycin and cefuroxime respectively.


CONCLUSIONS
Amoxicillin was found the most cost effective followed by clarithromycin and cefuroxime respectively in the treatment of non-severe and severe community-acquired pneumonia.
Aurangzeb
Brekhna
B
Department of Paediatrics, Khyber Teaching Hospital, Peshawar. bshifa@yahoo.com
Hameed
Abdul
A
D000658:Amoxicillin / Q000191:economics / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use*; D002444:Cefuroxime / Q000191:economics / Q000627:therapeutic use*; D002675:Child, Preschool; D017291:Clarithromycin / Q000191:economics / Q000627:therapeutic use*; D017714:Community-Acquired Infections / Q000188:drug therapy*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007223:Infant; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D011014:Pneumonia / Q000188:drug therapy*; D013997:Time Factors
D000900:Anti-Bacterial Agents; D000658:Amoxicillin; D017291:Clarithromycin; D002444:Cefuroxime