Pneumonia is a common cause of mortality and morbidity
in under-5 children throughout the world. Globally an estimated 156 million new
episodes of pneumonia occur each year in children and 2 million children die
from pneumonia each year which is 20 percent of all deaths of children under
five years old. Ceftriaxone is a commonly used drug for empiric treatment of
community acquired pneumonia (CAP) in children. Levofloxacin may be an adequate
option for empiric therapy in treatment of CAP in children because it gives the
broad spectrum activity against both bacterial and atypical pathogens causing
CAP and studies suggest that it can be safely used in children. This open
labeled, randomized, comparative clinical trial was carried out in the Department
of Pediatrics, Sylhet MAG Osmani Medical College Hospital, Bangladesh during
January, 2011 & December, 2012 to compare the efficacy of levofloxacin and
ceftriaxone in the treatment CAP in children. A total 70 cases of CAP were
enrolled. 35 cases were allocated to levofloxacin group and another 35 cases to
ceftriaxone group. At first the study cases were selected by systematic random
sampling. Group allocation to either levofloxacin or ceftriaxone group was done
by lottery method. Total duration for receiving study drugs was seven days.
Dose of levofloxacin was 10 mg/kg/day children ≥5 years, where as it was 10 mg/kg
12 hourly in 6 months to <5 years age groups. Dose of ceftriaxone was 75 mg/kg/day.
Response to treatment was assessed initially after 3 days and also after 7 days
by clinical symptoms and signs. Clinical cure rate was determined by
disappearance of the clinical signs and symptoms of pneumonia and resolution of
radiological findings reported at admission. Clinical
responses were categorized as cured and treatment failure. 91.43% cases
were cured in levofloxacin group, whereas
cure rate of ceftriaxone group was 68.57% which was statistically
significant (p = 0.0168). Adverse effects of levofloxacin were found as skin
rash in 1 case and vomiting in 2 cases whereas skin rash was found in 1 case in
ceftriaxone group. So it can be concluded that levofloxacin is more effective
than ceftriaxone in the treatment of CAP in children.
Cite this paper
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, 266-269. doi: 10.4236/ojped.2013.33046
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