The Indian Journal of Pediatrics

, Volume 73, Issue 4, pp 305–309

Penicillin and gentamicin therapyvs amoxicillin/clavulanate in severe hypoxemic pneumonia

Original Article


Objective: To compare the efficacy of sequential injectable crystalline penicillin (C.pen) and gentamicin combination followed by amoxicillin with sequential IV and oral amoxicillin-clavulanate (amox-clav) in treatment of severe or very severe hypoxemic pneumonia.Methods: Children aged 2–59 months with WHO-defined severe or very severe pneumonia with hypoxemia (SpO2<90%) were included in the study. Patients with fever>10 days, bacterial meningitis, prior antibiotic therapy >24 hours, stridor, heart disease and allergy to any of the study drugs were excluded. They were randomly allocated to two groups—Group A and Group B. Group A received C. pen and gentamicin intravenously (IV), followed by oral amoxicillin and group B got amox-clav IV, followed by oral amox-clav. Minimum duration of IV therapy was 3 days and total 7 days. Respiratory rate, oxygen saturation and chest wall indrawing were monitored 6 hourly.Results: 71 patients were included. There were two (5.2%) blood cultures positive in group A and three (9%) in group B. Organisms isolated wereS. pneumoniae (n=3) andH. influenzae-b (n=2). There was only one treatment failure in each of the groups. One was due to penicillin resistantH. influenzae-b and the other was due to worsening of pneumonia. The mean time taken for normalization of tachypnea, hypoxia, chest wall indrawing and inability to feed was similar (P-N.S). Mean duration of IV therapy in group A was 76±25 hrs and group B was 75±24 hrs (p>0.1).Conclusion: In children of 2–59 months, sequential injectable C. pen and gentamicin combination, followed by oral amoxicillin or sequential IV and oral amox-clav were equally effective for the treatment of severe or very severe hypoxemic community acquired pneumonia.

Key words

Acute respiratory infections Community acquired pneumonia Penicillin Gentamicin Amoxicillin/clavulanate 


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Copyright information

© Dr. K C Chaudhuri Foundation 2006

Authors and Affiliations

  1. 1.Department of Pediatrics, Advanced Pediatrics CenterPost Graduate Institute of Medical Education and Research CenterChandigarh
  2. 2.Pediatric Emergency and Intensive Care Units, Advanced Pediatrics CenterPGIMERChandigarh

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