Failure of standard antimicrobial therapy in children aged 3-59 months with mild or asymptomatic HIV infection and severe pneumonia.

Bulletin of the World Health Organization
Prakash JeenaAmoxicillin Penicillin Pneumonia International Study (APPIS Group)

Abstract

To determine whether children aged 3-59 months with mild or non-symptomatic human immunodeficiency virus (HIV) infection and WHO-defined severe pneumonia have a higher failure rate than do HIV-uninfected children when treated with the standard WHO treatment of parenteral penicillin or oral amoxicillin. This study was a planned sub-analysis of a randomized trial of 3-59-month-old children presenting with WHO-defined severe pneumonia (the APPIS study). We included two sites with high HIV prevalence in Durban, South Africa and Ndola, Zambia. Primary outcome measures were clinical treatment failure at day 2 and day 14. CLINICALTRIALS.GOV IDENTIFIER: CT00227331http://www.clinicaltrialsgov/show/NCT00227331). Of the 523 children enrolled, HIV status was known for 464 participants; 106 (23%) of these were infected with HIV. By day 2, 57 (12.3%) children had failed treatment and 110 (23.7%) failed by day 14. Twenty (18.9%) HIV-infected children failed by day 2 compared with 37 (10.3%) uninfected children (adjusted odds ratio (OR) 2.07; 95% confidence interval (CI): 1.07-4.00). Thirty-four (32.1%) HIV-infected children failed treatment by day 14 compared with 76 (21.2%) uninfected children (adjusted OR 1.88; 95% CI: 1.11-3.17). Analysis ...Continue Reading

Citations

Dec 25, 2012·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Matthew P FoxUNKNOWN Pneumonia Studies Group
May 1, 2007·The Pediatric Infectious Disease Journal·Philip Ayieko, Mike English
Jun 14, 2012·The Pediatric Infectious Disease Journal·Clare WebbJames A Berkley
Sep 23, 2006·BMJ : British Medical Journal·Zulfiqar A Bhutta
Jun 12, 2008·Bulletin of the World Health Organization·Prakash Mohan Jeena
Mar 29, 2014·Annals of the American Thoracic Society·Thomas Ferkol, Dean Schraufnagel

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