COMPARISON OF EFFICACY AND SAFETY OF PIPERACILLIN/TAZOBACTAM PLUS AMIKACIN (PTA) VERSUS CEFTRIAXONE PLUS AMIKACIN (CA) IN MANAGEMENT OF COMPLICATED PNEUMONIAS IN CHILDREN

Jyoti Kaushal, Dhiren M Pranami*, Sanjiv Nanda, Madhu Sharma

ABSTRACT

Objectives: This study aimed to compare the efficacy and safety of piperacillin/tazobactam plus amikacin versus ceftriaxone plus amikacin for treating complicated pneumonias in children. Materials and Methods: A prospective, randomized, comparative, open label & parallel study was done on 40 children of either sex and age between 2 to 14 years having complicated pneumonia.They were randomly allocated with the help of computer generated random numbers to receive either piperacillin/tazobactam plus amikacin(PTA group) or ceftriaxone plus amikacin(CA group). Efficacy assessment was done by observing sign and symptoms of pneumonia i.e fever, cough (productive or non-productive), dyspnoea, chest pain etc. & laboratory investigations like chest X-ray & pleural fluid examination. The number of days patients were hospitalized, was noted and a record was maintained. The number of patients who required oxygen inhalation and needed mechanical ventilation, was also noted. Safety assessment was done by observing the side effects of antibiotic therapy. Results: Duration of fever in PTA group was 3.70 ± 0.46 days while in CA group it was 5.30 ± 0.51 days. This difference was statistically significant (p < 0.05). Duration of hospital stay in PTA group was 12.00 ± 0.95 days and in CA group was 14.70 ± 0.70 days and this difference was statistically significant with the p value of 0.028. Sixteen (80%) patients in PTA group were cured whereas in CA group thirteen (65%) patients were cured. Regarding the therapeutic success of medication, no statistically significant difference was observed between the two groups, although more patients were cured and less had failure with treatment in PTA group as compared to CA group. Both the treatment regimens were well tolerated with minor ADRs. Conclusions : Both the treatment groups i.e. piperacillin/tazobactam plus amikacin (PTA) and ceftriaxone plus amikacin (CA) were found to be safe & efficacious in management of complicated pneumonia in children. On comparing the above mentioned treatment groups, better response was observed in PTA as compared to CA group.

Keywords: Childhood Pneumonias, Complicated Pneumonias, Piperacillin/Tazobactam, Ceftriaxone, Amikacin.