Retrospective analysis of the efficacies of two different regimens of aqueous penicillin G administered to children with pneumonia

Abstract

Community-acquired pneumonia (CAP) is an important childhood health problem. Penicillin remains appropriate for treating children with CAP. Clinical data are lacking on disease evolution in children treated with different posologic schemes of aqueous penicillin G. To assess if there were differences in disease evolution between children with CAP treated with 6 or 4 daily doses of aqueous penicillin G, we reviewed the medical charts of hospitalized patients 2 months to 11.5 years of age. Pneumonia was radiologically confirmed based on the detection of pulmonary infiltrate or pleural effusion on the chest radiograph taken on admission and read by a pediatric radiologist blinded to the clinical data. The total daily dose of aqueous penicillin G was 200,000 IU/kg of body weight. Data were recorded on admission, during disease evolution up to the 7th day of treatment, and at the final outcome. The results of hospitalization and the daily frequency of physical signs suggestive of pneumonia were assessed. The subgroups comprised 120 and 144 children who received aqueous penicillinGin 6 or 4 daily doses, respectively. Children ≥5 years of age were more frequent in the 4-daily-doses subgroup (16.0% versus 4.2%; respectively, P = 0.02). There were no differences between the compared subgroups in terms of final outcomes, lengths of hospitalization, durations of aqueous penicillin G use, frequencies of aqueous penicillinGsubstitution, or daily frequencies of tachypnea, fever, chest retraction, lower chest recession, nasal flaring, and cyanosis up to the 7th day of treatment. The studied posologic regimens were similarly effective in treating children hospitalized with a radiologically confirmed CAP diagnosis. Aqueous penicillin G (200,000 IU/kg/day) may be given in 4 daily doses to children with CAP. Copyright © 2014, American Society for Microbiology. All Rights Reserved.