CLINICAL RESEARCH
Comparison of the effectiveness of penicillin and broad-spectrum β-lactam antibiotics in the treatment of community-acquired pneumonia in children
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1
Department of Pediatrics, University Medical Centre, Maribor, Slovenia
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Department of Pediatrics, Faculty of Medicine, University of Maribor, Maribor, Slovenia
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Section of Dental Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
Submission date: 2020-04-05
Final revision date: 2020-07-05
Acceptance date: 2020-07-16
Online publication date: 2020-08-20
 
 
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ABSTRACT
Introduction:
Bacterial community-acquired pneumonia (CAP) in children is caused mostly by Streptococcus pneumoniae. The resistance of pneumococci to penicillin is increasing. However, most guidelines still prefer treatment with narrow-spectrum antibiotics. Therefore, we compared the effect of intravenous treatment with penicillin and broad-spectrum β-lactam antibiotics in children with CAP. The objective of our study was to assess the eligibility of treatment of bacterial CAP with intravenous penicillin.

Material and methods:
We performed a prospective study and included 136 children hospitalised because of bacterial CAP. Patients were treated intravenously with either penicillin G or broad-spectrum β-lactam antibiotic monotherapy. Lung ultrasound and blood tests were performed at admission and after 2 days of treatment. The time interval from the application of antibiotics to permanent defervescence was recorded.

Results:
Eighty-seven (64.0%) patients were treated with penicillin G, and 49 (36.0%) were treated with broad-spectrum β-lactam antibiotics. The median time to persistent defervescence was 5 h in the penicillin group and 8 h in the broad-spectrum group (p = 0.18). There were no significant differences between the treatment regimens regarding the effect on the consolidation sizes or C-reactive protein levels. However, the decrease in the white blood cell count was marginally greater in the penicillin treatment group (p = 0.05).

Conclusions:
We have shown that penicillin is as effective as broad-spectrum antibiotics in the treatment of bacterial CAP in children. Although the resistance of pneumococci to antibiotics is increasing, clinicians should still use penicillin and other narrow-spectrum β-lactam antibiotics in the treatment of bacterial CAP in children.

eISSN:1896-9151
ISSN:1734-1922