Resumen

PIREZ, MARíA CATALINA et al. Neumonía bacteriana adquirida en la comunidad en niños hospitalizados. Arch. Pediatr. Urug. [online]. 2003, vol.74, n.1, pp.6-14. ISSN 1688-1249.

Introduction: bacterial pneumonia is a frequent cause of hospitalization in children. Treatment guidelines adapted to local epidemiology are being applied since 1997. Objective: describe clinical, radiologic and etiologic characteristics of children hospitalized with community-acquired bacterial pneumonia (CABP) and evaluate compliance and validity of antimicrobial treatment with penicillin and derivates (ampicillin, amoxicillin) and/or macrolides. Method: from 19^th May, 1999 through 18^th May, 2000 children from one month to 14 years old hospitalized at the Centro Hospitalario Pereira Rossell with CABP were studied. On admission chest radiography and blood culture were performed as well as pleural fluid study when indicated. Children were treated according to the above mentioned guidelines. Results: 697 children (7,7% of all patients discharged in the study period) were included. Children under five years were predominant. Chest radiography showed pulmonary consolidation in 95% of the cases. In 76 of 77 children S. pneumoniae was indentified. Pneumococcal serotypes 5, 14 and 1 were the most prevalent, the 4 penicillin resistant strains (CIM ³ 2 µg/ml) corresponded to serotype 14. Empyema was diagnosed in 16% of the children. Treatment guidlines were followed in 93% of the cases. Eight children died; in four of them S. pneumoniae was identified, none was penicillin-resistant. Conclusions: recommended treatment guidelines remain valid. Empyema risk factors should be investigated. In order to diminish morbidity and mortality due to pneumonia, improving prevention strategies at primary level and knowledge of S. pneumoniae serotypes in order to consider possible future vaccination, are required.

Palabras clave : PNEUMONIA; STREPTOCOCCUS PNEUMONIAE; ANTIBIOTICS [therapeutic use].

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