title: Outcome of children hospitalized with community-acquired pneumonia treated with aqueous penicillin G.
abstract: OBJECTIVE
  To describe the evolution and outcome of children hospitalized with community-acquired pneumonia receiving penicillin.
  
  
  METHODS
  A search was carried out for all hospitalized community-acquired pneumonia cases in a 37-month period. Inclusion criteria comprised age >2 months, intravenous penicillin G use at 200,000 IU/kg/day for >48 h and chest x-ray results. Confounders leading to exclusion included underlying debilitating or chronic pulmonary illnesses, nosocomial pneumonia or transference to another hospital. Pneumonia was confirmed if a pulmonary infiltrate or pleural effusion was described by an independent radiologist blind to the clinical information. Data on admission and evolution were entered on a standardized form.
  
  
  RESULTS
  Of 154 studied cases, 123 (80%) and 40 (26%) had pulmonary infiltrate or pleural effusion, respectively. Penicilli was substituted by other antibiotics in 28 (18%) patients, in whom the sole significant decrease was in the frequency of tachypnea from the first to the second day of treatment (86% vs. 50%, p = 0.008). Among patients treated exclusively with penicillin G, fever (46% vs. 26%, p = 0.002), tachypnea (74% vs. 59%, p = 0.003), chest indrawing (29% vs. 13%, p<0.001) and nasal flaring (10% vs. 1.6%, p = 0.001) frequencies significantly decreased from admission to the first day of treatment. Patients treated with other antimicrobial agents stayed longer in the hospital than those treated solely with penicillin G (16 ± 6 vs. 8 ± 4 days, p<0.001, mean difference (95% confidence interval) 8 (6-10)). None of the studied patients died.
  
  
  CONCLUSIONS
  Penicillin G successfully treated 82% (126/154) of the study group and improvement was marked on the first day of treatment.
authors: School of Medicine, Federal University of Bahia, Salvador, Brazil.
authors: Raquel
authors: R
authors: Simbalista
authors: Marcelo
authors: M
authors: Araújo
authors: Cristiana M
authors: CM
authors: Nascimento-Carvalho
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001938:Brazil; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D017714:Community-Acquired Infections / Q000188:drug therapy; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010400:Penicillin G / Q000627:therapeutic use*; D018410:Pneumonia, Bacterial / Q000188:drug therapy*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D010400:Penicillin G