caa a22 4500 47578488X CHVBK 20180406123655.0 cr unu---uuuuu 170329e20001101xx s 000 0 eng 10.1007/PL00008360 doi (NATIONALLICENCE)springer-10.1007/PL00008360 Narrow- versus broad-spectrum parenteral antimicrobials against common infections of childhood: a prospective and randomised comparison between penicillin and cefuroxime [Elektronische Daten] [Elina Vuori-Holopainen, Heikki Peltola, Markku JT Kallio] Overuse of broad-spectrum antimicrobials has resulted in increasing bacterial resistance in many countries. We hypothesised that common childhood infections requiring parenteral medication are still curable with narrow-spectrum and inexpensive penicillin. A prospective and randomised study was performed in two referral hospitals in Helsinki. A total of 154 children aged 3 months to 15 years with pneumonia or other lower respiratory infections, sepsis-like infections, or other common acute infections warranting hospitalisation and parenteral antimicrobials were included. At random, 50% of children received procaine penicillin intramuscularly, the other 50% cefuroxime intravenously for 4-7 days. The course of illness was monitored with predetermined laboratory and radiological indices, by filling in a special form daily and a follow-up for 30 days after discharge. The infectious agent was searched for with a large laboratory set-up covering 23 bacterial, viral or protozoan species. The two groups were very similar at presentation. Probable aetiology was disclosed in 56% of the penicillin and in 68% of the cefuroxime recipients, the leading agent in both groups being Pneumococcus. In 8% only a viral aetiology was found. The children recovered with the same speed, regardless of which antimicrobial used, there being one possible failure in each group but no difference in the frequency of needing a physician again within 1 month of discharge. No adverse event was attributable to either drug. Conclusion Procaine penicillin is as effective and safe as cefuroxime for common community-acquired infections in immunocompetent children. Springer-Verlag Berlin Heidelberg, 2000 Key words Antimicrobials nationallicence Cefuroxime nationallicence Penicillin nationallicence Pneumonia nationallicence Sepsis nationallicence AbbreviationsCRP C-reactive protein nationallicence Hib Haemophilus influenzae type b nationallicence MIC minimal inhibitory concentration nationallicence Vuori-Holopainen Elina Helsinki University Central Hospital, Hospital for Children and Adolescents, PB 281 00290 Helsinki, Finland e-mail: elina.vuori@helsinki.fi Tel.: +358-9-47171007; Fax: +358-9-47174708, FI aut Peltola Heikki Helsinki University Central Hospital, Hospital for Children and Adolescents, PB 281 00290 Helsinki, Finland e-mail: elina.vuori@helsinki.fi Tel.: +358-9-47171007; Fax: +358-9-47174708, FI aut Kallio Markku JT Helsinki University Central Hospital, Hospital for Children and Adolescents, PB 281 00290 Helsinki, Finland e-mail: elina.vuori@helsinki.fi Tel.: +358-9-47171007; Fax: +358-9-47174708, FI aut https://doi.org/10.1007/PL00008360 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/PL00008360 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Vuori-Holopainen Elina Helsinki University Central Hospital, Hospital for Children and Adolescents, PB 281 00290 Helsinki, Finland e-mail: elina.vuori@helsinki.fi Tel.: +358-9-47171007; Fax: +358-9-47174708, FI aut NATIONALLICENCE 700 1- Peltola Heikki Helsinki University Central Hospital, Hospital for Children and Adolescents, PB 281 00290 Helsinki, Finland e-mail: elina.vuori@helsinki.fi Tel.: +358-9-47171007; Fax: +358-9-47174708, FI aut NATIONALLICENCE 700 1- Kallio Markku JT Helsinki University Central Hospital, Hospital for Children and Adolescents, PB 281 00290 Helsinki, Finland e-mail: elina.vuori@helsinki.fi Tel.: +358-9-47171007; Fax: +358-9-47174708, FI aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer