title: IV Penicillin G is as effective as IV cefuroxime in treating community-acquired pneumonia in children.
abstract: Overuse of broad-spectrum antimicrobials has resulted in bacterial resistance and increasing use of relatively expensive antibiotics for community-acquired pneumonia (CAP). We hypothesized that CAP requiring parenteral medication is still curable with narrow-spectrum and inexpensive penicillin G. A prospective, randomized study was performed on 58 children aged 3 months to 15 years with CAP. Children were randomly assigned to receive low-dose penicillin G, high penicillin G, or cefuroxime intravenously for 4-7 days. The course of illness was monitored clinically and with predetermined laboratory and radiological indices for 30 days. The children recovered at the same rate with no significant differences in time to defervescence or duration of hospitalization. Observed differences in leukocyte counts and C-reactive protein at discharge were of questionable clinical significance. Penicillin G is as effective and safe as cefuroxime for CAP in otherwise healthy children, even in moderate doses.
authors.affiliation: 1Pediatrics Department and 2Division of Pediatric Emergency Medicine, Dana's Children Hospital, University of Tel Aviv, Tel Aviv, Israel; 3Division of Pediatric Emergency Medicine, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Canada; 4Division of Infectious Diisease, Department of Pediatrics, Dana's Children Hospital, University of Tel Aviv, Tel Aviv, Israel; and 5Department of Diagnostic Imaging, Ichilov Hospital, University of Tel Aviv, Tel Aviv, Israel.
authors.forename: Gil
authors.initials: G
authors.lastname: Amarilyo
authors.forename: Miguel
authors.initials: M
authors.lastname: Glatstein
authors.forename: Arik
authors.initials: A
authors.lastname: Alper
authors.forename: Dennis
authors.initials: D
authors.lastname: Scolnik
authors.forename: Moran
authors.initials: M
authors.lastname: Lavie
authors.forename: Nira
authors.initials: N
authors.lastname: Schneebaum
authors.forename: Galia
authors.initials: G
authors.lastname: Grisaru-Soen
authors.forename: Ayala
authors.initials: A
authors.lastname: Assia
authors.forename: Liat
authors.initials: L
authors.lastname: Ben-Sira
authors.forename: Shimon
authors.initials: S
authors.lastname: Reif
mesh_terms: D061605:Administration, Intravenous; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002097:C-Reactive Protein / Q000378:metabolism; D002444:Cefuroxime / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007902:Length of Stay; D007958:Leukocyte Count; D010400:Penicillin G / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011014:Pneumonia / Q000188:drug therapy*; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents; D002097:C-Reactive Protein; D002444:Cefuroxime; D010400:Penicillin G