Clinical failure among children with nonsevere community-acquired pneumonia treated with amoxicillin.
OBJECTIVE
To estimate the clinical failure and adverse events in children with nonsevere pneumonia receiving amoxicillin, identifying risk factors.


METHODS
192 patients aged 2 - 59 months were prospectively followed up. Pneumonia diagnosis was based on respiratory complaints and radiographic pulmonary infiltrate or pleural effusion. Amoxicillin (50 mg/kg/day) was given. Demographic data and clinical findings on admission, daily evolution up to the 5th day of treatment and 2 - 4 weeks after enrollment were collected.


METHODS
Clinical failure included persistence of fever, difficulty breathing or tachypnea beyond the first 48 h of treatment or of cough beyond the first 96 h of treatment or sign of severe/very severe disease up to the 5th day of treatment.


RESULTS
Amoxicillin failed in 6 (3.1%) cases. By excluding one child diagnosed with cystic fibrosis after continued follow-up, the final clinical failure rate was 2.6%. The total adverse effect frequency was 14 (7.3%), but amoxicillin was discontinued only in 1 (0.5%) case. No relapse was identified at the 2 - 4-week interval evaluation. By multivariate analysis, age (OR = 1.1; 95% CI 1.01 - 1.19) was an independent risk factor for clinical failure which occurred in older children (47 +/- 9 vs 31 +/- 16 months; p = 0.01).


CONCLUSIONS
Clinical failures were few, especially among those aged < 2 years. Amoxicillin discontinuation due to adverse reaction was rare.
Fontoura
Maria-Socorro H
MS
Department of Pediatrics, Federal University of Bahia School of Medicine, Rua Prof. Aristides Novis, 105/1201B, Salvador, CEP 40210-630, Brazil.
Araújo-Neto
César A
CA
Andrade
Sandra C S
SC
Brim
Rosa V
RV
Matutino
Adriana R
AR
Silva
Carolina C
CC
Santana
Milena C
MC
Nobre-Bastos
Monalisa
M
Oliveira
Felipe
F
Barreto
Bruna B
BB
Santos
Pablo M
PM
Noblat
Lúcia
L
Cardoso
Maria-Regina A
MR
Nascimento-Carvalho
Cristiana M
CM
D000658:Amoxicillin / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D018410:Pneumonia, Bacterial / Q000188:drug therapy*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000658:Amoxicillin