title: Clinical application of the rapid pneumococcal urinary antigen test in the treatment of severe pneumonia in children.
abstract: OBJECTIVE
  To evaluate the efficacy of the pneumococcal urinary antigen test (PUAT) in severe pediatric pneumonia.
  
  
  METHODS
  The study enrolled 245 pediatric patients with severe pneumonia. Patients were divided into four groups; groups 1 and 2 received PUAT, while groups 3 and 4 did not. Additionally, PUAT-positive group 1 patients were treated with penicillin, while PUAT-negative patients received ampicillin-sulbactam or cefuroxime. Group 2 patients were treated empirically without following the group 1 protocol. Group 3 patients were treated following the guideline of the Infectious Diseases Society of Taiwan (IDST), and group 4 patients were treated empirically without following the IDST guideline. Treatment was assessed by the duration of fever.
  
  
  RESULTS
  Treatment was most effective for group 1 and least effective for group 4. Group 2 treatment was superior to group 3 treatment. Multivariate regression analysis of groups 1 and 2 revealed that the use of PUAT (groups 1 and 2) was associated with superior response in comparison with group 4.
  
  
  CONCLUSIONS
  Application of PUAT and adequate antimicrobial treatments in the initial stage for pediatric patients with severe pneumonia resulted in improved outcome as assessed by shortening of the duration of fever.
authors.affiliation: Department of Pediatrics, Pingtung Christian Hospital, Pingtung, Taiwan.
authors.forename: Huey-Fung
authors.initials: HF
authors.lastname: Cheong
authors.forename: Luo-Ping
authors.initials: LP
authors.lastname: Ger
authors.forename: Ming-Ting
authors.initials: MT
authors.lastname: Wu
authors.forename: Chih-Pei
authors.initials: CP
authors.lastname: Sun
authors.forename: Kai-Sheng
authors.initials: KS
authors.lastname: Hsieh
authors.forename: Yung-Ching
authors.initials: YC
authors.lastname: Liu
authors.forename: Ming-Fang
authors.initials: MF
authors.lastname: Cheng
mesh_terms: D000293:Adolescent; D000942:Antigens, Bacterial / Q000652:urine*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005334:Fever / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D007159:Immunologic Tests / Q000379:methods*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011018:Pneumonia, Pneumococcal / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D013296:Streptococcus pneumoniae / Q000276:immunology* / Q000302:isolation & purification; D016896:Treatment Outcome
chemical_list: D000942:Antigens, Bacterial