Effectiveness of first 72 hours empirical antibiotic for pediatric pneumonia therapy in Dr. M. Djamil Hospital Padang period 2013-2014

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

2BackgroundRational treatment for pneumonia most likely pathogens in each community empiric antibiotic penicillin derivates first line therapyPneumonia , especially under 5 yo is the main cause of death in child, mostly cause by bacterial agent

However, the rapid global spread of antibiotic resistance may cause doubts on the effectiveness of empiric antibiotic therapy in these patients

WHO: 2014

ObjectiveTo 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

ResultTotal : 270 cases133 cases (subject)21 cases discharge before 72 hours 116 cases Medical record not complete

Characteristic subjectVariabelN %Gender Male7858.6 Female5541.4Age 1-2 months118.3 2-12 months8362.4 13-60 months3425.6 > 60 months53.8Nutritional status Malnourished32,3 Undernourished8563.9 Good 4533.8

Comorbid disease and complicated pneumonia

Empirically Antibiotic on first 72 hours pneumonia chidren

Respon of empirically antibiotic on 72 hours

The highest level was a combination of Amoxicillin-Chloramphenicol (97.4%). Severity of pneumoniaRespon of empirically antibiotic ImprovedfailedUncomplicated Pneumonia 73 (97,3%)2 (2,7%)Complicated Pneumonia23 ( 39,7%)35 (60,3%)

Respon empirical antibiotic on first 72 hours more effective on uncomplicated peneumonia than complicated pneumonia Length of StayRespon of empirically antibiotic on first 72 hoursimprovedfailed< 5 days48 (50 %)16 (43,2%)5-10 days40 (41,7 %)12 (32,4 %)P = 0,046>10 days8 (8,3 %)9 (24,3 %)

There was significant association with respon empirical antibiotic on first 72 hours with leght of stayOutcome

13Discussion

Children aged 259 months with severe pneumonia should be treated with parenteral penicillin group antibiotic and gentamicin or khloramfenicol as a first-line treatment Revised WHO classification and treatment of pneumonia in children at health facilities: evidence summariesGeneva: World Health Organization; 2014Penicillin group antibiotic was effective as empiric therapy for pneumonia children Discussion

Conclusion

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