Author | Carvalho, Cristiana Maria Costa Nascimento de | |
Author | Souza, Gabriel Xavier | |
Author | Vilas Boas, Ana Luisa | |
Author | Fontoura, Maria do Socorro Heitz | |
Author | Barral, Aldina Maria Prado | |
Author | Puolakkainen, Mirja | |
Author | Ruuskanen, Olli | |
Access date | 2018-02-15T13:18:22Z | |
Available date | 2018-02-15T13:18:22Z | |
Document date | 2017 | |
Citation | CARVALHO, C. M. C. N. et al. Evolution of acute infection with atypical bacteria in a prospective cohort of children with community-acquired pneumonia receiving amoxicillin. Journal of Antimicrobial Chemotherapy, v. 72, p. 2378–2384, 2017. | pt_BR |
ISSN | 0305-7453 | pt_BR |
URI | https://www.arca.fiocruz.br/handle/icict/24829 | |
Sponsorship | Bahia State Agency for Research Funding (FAPESB) (grant no. APR N . 0127/2006). C. M. N.-C. and
A. B. are investigators at the Brazilian Council for Scientific and Technological Development (CNPq). | pt_BR |
Language | eng | pt_BR |
Publisher | Oxfor University Press | pt_BR |
Rights | open access | pt_BR |
Subject in Portuguese | Pneumonia, Bacteriana | pt_BR |
Subject in Portuguese | Infecções Adquiridas na Comunidade | pt_BR |
Subject in Portuguese | Agentes antibacterianos | pt_BR |
Subject in Portuguese | Amoxicilina | pt_BR |
Subject in Portuguese | Humanos | pt_BR |
Subject in Portuguese | Infantil | pt_BR |
Title | Evolution of acute infection with atypical bacteria in a prospective cohort of children with community-acquired pneumonia receiving amoxicillin | pt_BR |
Type | Article | pt_BR |
DOI | 10.1093/jac/dkx126 | |
Abstract | Atypical bacteria are treatable causative agents of community-acquired pneumonia (CAP). However, there is no conclusive evidence that a child with CAP should receive empirical treatment against such agents. Objectives: We assessed the possibility of association between clinical failure and acute infection by these bacteria
among children with CAP treated with amoxicillin.
Patients and methods: Patients aged 2–59months with non-severe CAP received amoxicillin during prospective
follow-up. Acute and convalescent blood samples were collected. Probable acute infection by Mycoplasma
pneumoniae (specific IgM antibodies), by Chlamydia pneumoniae or Chlamydia trachomatis (specific IgM antibodies
and/or IgG/IgA titre change) was investigated. Outcomes were assessed during follow-up at 2, 5 and
14–28 days. Treatment failure included development of danger signs, persistent fever, tachypnoea or death.
ClinicalTrials.gov: NCT01200706.
Results: Of 787 children, 86 (10.9%; 95% CI"8.9%–13.3%) had acute M. pneumoniae infection. C. pneumoniae
acute infection was found in 79 of 733 (10.8%; 95% CI"8.7%–13.2%) and C. trachomatis was found in 3 of 28
(10.7%; 95%CI"2.8%–26.5%) ,6months old. Among patients with or without treatment failure at 2 days, acute
M. pneumoniae infection (11.7% versus 10.7%; P"0.7), acute C. pneumoniae infection (8.5% versus 11.3%;
P"0.3) and acute C. trachomatis infection (16.7% versus 9.1%; P"0.5) were found. No significant differences
were found with regard to treatment failure at the 5 day evaluation. Overall, amoxicillin was substituted in 3.5%
versus 2.7%among patientswith orwithout acute infection by one of these bacteria (P"0.6).
Conclusions: The overall substitution rate of amoxicillin was very low. It is not necessary to give an empirical nonb-
lactamantibiotic as a first-line option to treat every child between 2 and 59months old with non-severe CAP. | pt_BR |
Affilliation | Universidade Federal da Bahia. Escola de Medicina. Departamento de Pediatria. Salvador, BA, Brasil | pt_BR |
Affilliation | Universidade Federal da Bahia. Escola de Medicina. Departamento de Pediatria. Salvador, BA, Brasil | pt_BR |
Affilliation | Universidade Federal da Bahia. Escola de Medicina. Departamento de Pediatria. Salvador, BA, Brasil | pt_BR |
Affilliation | Universidade Federal da Bahia. Escola de Medicina. Departamento de Pediatria. Salvador, BA, Brasil | pt_BR |
Affilliation | Universidade Federal da Bahia. Escola de Medicina. Departamento de Patologia. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil | pt_BR |
Affilliation | University of Helsinki and University Central Hospital. Virology. Helsinki, Finland | pt_BR |
Affilliation | University of Turku. Department of Paediatrics. Turku, Finland | pt_BR |
Subject | Pneumonia, Bacterial | pt_BR |
Subject | Community-Acquired Infections | pt_BR |
Subject | Anti-Bacterial Agents | pt_BR |
Subject | Amoxicillin | pt_BR |
Subject | Humans | pt_BR |
Subject | Infant | pt_BR |