Clinical application of the rapid pneumococcal urinary antigen test in the treatment of severe pneumonia in children.
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.
Cheong
Huey-Fung
HF
Department of Pediatrics, Pingtung Christian Hospital, Pingtung, Taiwan.
Ger
Luo-Ping
LP
Wu
Ming-Ting
MT
Sun
Chih-Pei
CP
Hsieh
Kai-Sheng
KS
Liu
Yung-Ching
YC
Cheng
Ming-Fang
MF
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
D000942:Antigens, Bacterial