BAGIAN / KSM ILMU KESEHATAN ANAK

FK UNAND / RSUP DR.M.DJAMIL PADANG

Effectiveness of first 72 hours empirical antibiotic for

pediatric pneumonia therapy
in Dr. M. Djamil Hospital Padang period 2013-2014

Ranti Adriani, Finny Fitry Yani, Darfioes Basir

Department of Pediatrics, Medical Faculty, Andalas
University, Padang, Indonesia

Background
Pneumonia , especially under 5 yo is the main
cause of death in child, mostly cause by bacterial
agent
Rational treatment for pneumonia most likely
pathogens in each community empiric
antibiotic penicillin derivates first line therapy
However, the rapid global spread of antibiotic
resistance may cause doubts on the effectiveness
of empiric antibiotic therapy in these patients
WHO: 2014

Objective
To assess the Effectiveness of first 72
hours empirical antibiotic for
pediatric pneumonia therapy in Dr.
M. Djamil Hospital Padang period
januari 2013- desember 2014

METHODS

Result
Total : 270
cases

116 cases
Medical
record not
complete

21 cases
discharge
before 72
hours
133 cases
(subject)

Characteristic subject
Variabel

Male

78

58.6

Female

55

41.4

1-2 months

11

8.3

2-12 months

83

62.4

13-60 months

34

25.6

> 60 months

3.8

2,3

Undernourished

85

63.9

Good

45

33.8

Gender

Age

Nutritional status

Malnourished

Comorbid disease and

complicated pneumonia
complicated

complicated pneumonia

uncomplicat
ed

56%

44%

2% 3%
9%
35%
12%
19%

21%

sepsis
CHD
meningitis
apnue
cerebral
palsy
malignancy
diarhea

Empirically Antibiotic
on first 72 hours
pneumonia chidren
3.8
2.3
1.5
5.3
28.6

14.3

44.4

amoxicillingentamisin
amoxicillinkhloramfenikol
ampicillin-gentamicin
ampicillinkhloramfenikol
cefotaxim
meropenem
ceftriaxone

Respon of empirically antibiotic

on 72 hours
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%

72.9

97.4
42.9

50

failed
improved

The highest level

was a
combination of
AmoxicillinChloramphenicol
(97.4%).


Severity of
pneumonia

Respon of empirically antibiotic

Improved

failed

Uncomplicated
Pneumonia

73 (97,3%)

2 (2,7%)

Complicated Pneumonia

23 ( 39,7%)

35 (60,3%)

Respon empirical antibiotic on first 72 hours

more effective on uncomplicated peneumonia
than complicated pneumonia


Length of Stay

Respon of empirically antibiotic

on first 72 hours
improved

< 5 days

48 (50 %)

5-10 days

40 (41,7 %)

>10 days

8 (8,3 %)

failed

16 (43,2%)
12 (32,4 %)

P = 0,046

9 (24,3 %)

There was significant association with respon

empirical antibiotic on first 72 hours with leght of
stay

Outcome
outcome

improvement
death

The end of hospitalized, there were clinicaly

improvement 79.7% and death 20.3%.

Discussion
Penicillin group antibiotic was effective as empiric
therapy for pneumonia children

Children aged 259 months with severe pneumonia

should be treated with parenteral penicillin group
antibiotic and gentamicin or khloramfenicol as a firstline treatment
Revised WHO classification and treatment of pneumonia in children at health facilities: evidence
summariesGeneva: World Health Organization; 2014

Discussion

Effectiveness of first 72 hours empirical antibio

Conclusion
Antibiotics empirically assessed was
effective in treatment pneumonia
Respon empirical antibiotic on first 72 hours more
effective on uncomplicated peneumonia than
complicated of pneumonia
There was significant association respon empirical
antibiotic with leght of stay

Thank you