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A Randomized Controlled Trial of Penicillin vs Clindamycin for the Treatment of Aspiration Pneumonia in Children

Sheila J. Jacobson, MBBCh; Kathryn Griffiths; Shelley Diamond; Patricia Winders, RN; Michael Sgro, MD; William Feldman, MD; Colin Macarthur, MBBCh, PhD
Arch Pediatr Adolesc Med. 1997;151(7):701-704. doi:10.1001/archpedi.1997.02170440063011.
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Objective:  To compare the effectiveness of intravenous penicillin vs clindamycin for the treatment of aspiration pneumonia.

Design:  A double-blind, randomized controlled trial.

Setting:  A tertiary care pediatric hospital.

Patients:  We enrolled 42 children, aged 6 months to 18 years, who were admitted to the hospital for the treatment of aspiration pneumonia. All of the children had underlying conditions that predispose to aspiration.

Intervention:  The patients were randomly assigned to receive intravenous penicillin G sodium, 250 000 U/kg every 24 hours, or intravenous clindamycin phosphate, 30 mg/kg every 24 hours.

Main Outcome Measure:  The primary outcome measure was "time to ready for discharge" from the hospital.

Results:  In an effectiveness (intention to treat) analysis, the median time (interquartile range) to ready for discharge from the hospital was 4.9 days (range, 2.8-6.5 days) in the penicillin-treated group and 3.4 days (range, 2.3-6.8 days) in the clindamycin-treated group (P=.66). Results were not markedly altered when adjusted for the age difference of the groups or in the efficacy analysis (after the exclusion of 9 patients who withdrew from the trial). Rates for readmission to the hospital were similar in the 2 groups.

Conclusion:  Penicillin and clindamycin seem to be equally effective for the treatment of aspiration pneumonia in children hospitalized for this illness.Arch Pediatr Adolesc Med. 1997;151:701-704

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