Effectiveness of early switch from intravenous to oral antibiotics in severe pneumonia

Abstract

Objectives: Globally, pneumonia is the leading cause of childhood morbidity and mortality. The W.H.O. in its guidelines for the management of severe pneumonia advised that these cases be referred to hospital for inpatient management with parenteral antibiotics. This study was conducted to compare the effectiveness of early switch from intravenous to oral antibiotics in severe pneumonia; and the average duration of stay of children in hospital in both the groups.

Setting: Tertiary care hospital.

Study design: prospective and observational.

Participants: Children classified as severe pneumonia aged 2 to 60 months.

Intervention: Children were randomly divided into two groups,

Group I: received intravenous antibiotic ( ampicillin ) at the dose of 200 mg/ Kg / day/ 6 hourly.

Group II: switched to oral amoxycillin at the dose of 40 mg/ Kg / day/ 8 hourly, after two days of intravenous treatment with ampicillin with same dose as in Group I. General supportive care was provided when indicated. Children were monitored and evaluated for the response to the therapy.

Results and Conclusion: There was a similar rate of improvement in the signs of respiratory distress in the two groups and difference in the treatment outcome of the two groups was not statistically significant. The duration of stay in hospital of children in whom intervention with switch on to oral antibiotics was made was significantly reduced. There was reduction in the rate of complications such as oedema/ extravasation, inflammation, abscess at site of cannula in the children in whom switch on to oral antibiotics was made.