title: Clinical failure among children with nonsevere community-acquired pneumonia treated with amoxicillin.
abstract: 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.
authors.affiliation: Department of Pediatrics, Federal University of Bahia School of Medicine, Rua Prof. Aristides Novis, 105/1201B, Salvador, CEP 40210-630, Brazil.
authors.forename: Maria-Socorro H
authors.initials: MS
authors.lastname: Fontoura
authors.forename: César A
authors.initials: CA
authors.lastname: Araújo-Neto
authors.forename: Sandra C S
authors.initials: SC
authors.lastname: Andrade
authors.forename: Rosa V
authors.initials: RV
authors.lastname: Brim
authors.forename: Adriana R
authors.initials: AR
authors.lastname: Matutino
authors.forename: Carolina C
authors.initials: CC
authors.lastname: Silva
authors.forename: Milena C
authors.initials: MC
authors.lastname: Santana
authors.forename: Monalisa
authors.initials: M
authors.lastname: Nobre-Bastos
authors.forename: Felipe
authors.initials: F
authors.lastname: Oliveira
authors.forename: Bruna B
authors.initials: BB
authors.lastname: Barreto
authors.forename: Pablo M
authors.initials: PM
authors.lastname: Santos
authors.forename: Lúcia
authors.initials: L
authors.lastname: Noblat
authors.forename: Maria-Regina A
authors.initials: MR
authors.lastname: Cardoso
authors.forename: Cristiana M
authors.initials: CM
authors.lastname: Nascimento-Carvalho
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents; D000658:Amoxicillin