Teotico, Anton

Objective
To evaluate whether five days treatment with injectable ampicillin plus gentamicin compared with chloramphenicol reduces treatment failure in children aged 2-59 months with community acquired very severe pneumonia in low resource settings.

Methods
Open label randomised controlled trial Inpatient wards within tertiary care hospitals in Bangladesh, Ecuador, India, Mexico, Pakistan, Yemen, and Zambia Children aged 2-59 months with WHO defined very severe pneumonia Intervention: Chloramphenicol versus a combination of ampicillin plus gentamicin Main outcome measures: Primary outcome measure was treatment failure at five days

Results

Conclusion
injectable ampicillin plus gentamicin is more effective in the treatment of very severe pneumonia (compared to chloramphenicol) in children aged 2-59 months.

Journal

Clinical Query
Is the co-trimoxazole superior than amoxicillin in providing relief of symptoms in toddlers with pneumonia?

P: toddlers with pneumonia I: amoxicillin O: resolution of symptoms of pneumonia M: randomized control trial

NIH Public Access

Author Manuscript
Lancet. Author manuscript; available in PMC 2013 June 18.
Published in final edited form as: Lancet. 2011 November 19; 378(9805): 17961803. doi:10.1016/S0140-6736(11)61140-9.

Cluster Randomized Trial of Community Case Management of Severe Pneumonia with Oral Amoxicillin in Children 2-59 Months of Age in Haripur District, Pakistan
Abdul Bari, MBBS, MSc 1, Salim Sadruddin, MBBS, MPH, PhD 2, Attaullah Khan, MBBS MPH1, Ibad ul Haque Khan, MSc 1, Aman Ullah, MBBS, MPH 1, Iqbal A. Lehri, MS, MCPS, DOS, BDS3, William B. Macleod, DSc 4,5, Matthew P. Fox, DSc 5,6, Donald M Thea, MD, MSc4,5, and Shamim A. Qazi, MBBS, MSc, MD 7
1Save

the Children US, Pakistan Country Office 2Save the Children US, Westport, USA 3National Program for Family Planning and Primary Health Care, Pakistan 4Department of International Health, Boston University School of Public Health, Boston, USA 5Center for Global Health and Development, Boston University, Boston, USA 6Department of Epidemiology, Boston University NIH Public Access School of Public Health, Boston, USA 7World Health Organization, Department of Child and Author Manuscript Adolescent Health and Development, Geneva, Lancet . Author manuscript; available in Switzerland PMC 2013 June 18.

Abstract

Published in final edited form as: Lancet. 2011 November 19; 378(9805): 17961803. doi:10.1016/S0140-6736(11)61140-9.

Background First dose oral cotrimoxazole and referral is the recommended treatment for

NIH-PA Au

Objective
To determine if clinical treatment failure rates among children 2-59 months with WHOdefined severe pneumonia receiving community treatment by LHWs with oral amoxicillin was equivalent to that of children receiving standard of care.

Methods
cluster-randomized equivalence trial 2-59 months of age with severe pneumonia Intervention: oral amoxicillin and cotrimoxazole Primary outcome: treatment failure on day 6 of treatment

Results
Treatment failure 8.9% in amoxicillin group and 17.8% in cotrimoxazole group 3 deaths in cotrimoxazole group 1 death in amoxicillin group

Conclusion
Community case management of WHO defined severe pneumonia in children aged 259 months by local health workers resulted in less treatment failure than the current standard of care practice of one dose of oral cotrimoxazole and referral to nearest health facility for further treatment.