Clinical effectiveness of co-trimoxazole vs. Amoxicillin in the treatment of non-severe pneumonia in children in India

A randomized controlled trial

Shimoga Mahabala Rajesh, Vikram Singhal

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Acute respiratory infection (ARI) in young children is responsible for an estimated 4.1 million deaths worldwide of which approximately 90% are due to pneumonia. To study the clinical effectiveness of co-trimoxazole versus amoxicillin in the treatment of non-severe pneumonia, as defined by WHO, in children in the age group of 02 months to 5 years. Randomized Control Trial study was conducted in out patient department of a large tertiary care hospital after taking consent from parents and ethical committee clearance. Methods: Children in study group were treated with amoxicillin (40 mg/kg/day in 3 divided doses) and those in control group were treated with co-trimoxazole (8 mg/kg/day of trimethoprim in 2 divided doses). All cases were reviewed on second and fifth day. The effectiveness and therapy failure were decided on the basis of clinical, radiological and complete blood count results. Results: Two hundred and four cases of non severe pneumonia were studied. All cases were diagnosed on the basis of clinical criteria, as defined by WHO. Treatment failure was seen in 8.09% cases with amoxicillin and 39.05% cases with co-trimoxazole. Cost of one complete course with amoxicillin was 2.3 times higher than with co-trimoxazole. Compliance of therapy to co-trimoxazole (90.47%) was better than to amoxicillin (83.84%). Conclusions: The response to treatment with amoxicillin is faster, however, compliance is slightly poorer and cost of treatment high. In order to improve the compliance, better counseling and more studies are required to ascertain the efficacy of amoxicillin in higher dosage over a shorter period of time.

Original languageEnglish
Pages (from-to)1162-1168
Number of pages7
JournalInternational Journal of Preventive Medicine
Volume4
Issue number10
Publication statusPublished - 18-10-2013

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Amoxicillin
Sulfamethoxazole Drug Combination Trimethoprim
India
Pneumonia
Randomized Controlled Trials
Therapeutics
Compliance
Trimethoprim
Blood Cell Count
Tertiary Healthcare
Treatment Failure
Tertiary Care Centers
Respiratory Tract Infections
Health Care Costs
Counseling
Age Groups
Parents
Costs and Cost Analysis
Control Groups

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health

Cite this

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title = "Clinical effectiveness of co-trimoxazole vs. Amoxicillin in the treatment of non-severe pneumonia in children in India: A randomized controlled trial",
abstract = "Background: Acute respiratory infection (ARI) in young children is responsible for an estimated 4.1 million deaths worldwide of which approximately 90{\%} are due to pneumonia. To study the clinical effectiveness of co-trimoxazole versus amoxicillin in the treatment of non-severe pneumonia, as defined by WHO, in children in the age group of 02 months to 5 years. Randomized Control Trial study was conducted in out patient department of a large tertiary care hospital after taking consent from parents and ethical committee clearance. Methods: Children in study group were treated with amoxicillin (40 mg/kg/day in 3 divided doses) and those in control group were treated with co-trimoxazole (8 mg/kg/day of trimethoprim in 2 divided doses). All cases were reviewed on second and fifth day. The effectiveness and therapy failure were decided on the basis of clinical, radiological and complete blood count results. Results: Two hundred and four cases of non severe pneumonia were studied. All cases were diagnosed on the basis of clinical criteria, as defined by WHO. Treatment failure was seen in 8.09{\%} cases with amoxicillin and 39.05{\%} cases with co-trimoxazole. Cost of one complete course with amoxicillin was 2.3 times higher than with co-trimoxazole. Compliance of therapy to co-trimoxazole (90.47{\%}) was better than to amoxicillin (83.84{\%}). Conclusions: The response to treatment with amoxicillin is faster, however, compliance is slightly poorer and cost of treatment high. In order to improve the compliance, better counseling and more studies are required to ascertain the efficacy of amoxicillin in higher dosage over a shorter period of time.",
author = "Rajesh, {Shimoga Mahabala} and Vikram Singhal",
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T1 - Clinical effectiveness of co-trimoxazole vs. Amoxicillin in the treatment of non-severe pneumonia in children in India

T2 - A randomized controlled trial

AU - Rajesh, Shimoga Mahabala

AU - Singhal, Vikram

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Y1 - 2013/10/18

N2 - Background: Acute respiratory infection (ARI) in young children is responsible for an estimated 4.1 million deaths worldwide of which approximately 90% are due to pneumonia. To study the clinical effectiveness of co-trimoxazole versus amoxicillin in the treatment of non-severe pneumonia, as defined by WHO, in children in the age group of 02 months to 5 years. Randomized Control Trial study was conducted in out patient department of a large tertiary care hospital after taking consent from parents and ethical committee clearance. Methods: Children in study group were treated with amoxicillin (40 mg/kg/day in 3 divided doses) and those in control group were treated with co-trimoxazole (8 mg/kg/day of trimethoprim in 2 divided doses). All cases were reviewed on second and fifth day. The effectiveness and therapy failure were decided on the basis of clinical, radiological and complete blood count results. Results: Two hundred and four cases of non severe pneumonia were studied. All cases were diagnosed on the basis of clinical criteria, as defined by WHO. Treatment failure was seen in 8.09% cases with amoxicillin and 39.05% cases with co-trimoxazole. Cost of one complete course with amoxicillin was 2.3 times higher than with co-trimoxazole. Compliance of therapy to co-trimoxazole (90.47%) was better than to amoxicillin (83.84%). Conclusions: The response to treatment with amoxicillin is faster, however, compliance is slightly poorer and cost of treatment high. In order to improve the compliance, better counseling and more studies are required to ascertain the efficacy of amoxicillin in higher dosage over a shorter period of time.

AB - Background: Acute respiratory infection (ARI) in young children is responsible for an estimated 4.1 million deaths worldwide of which approximately 90% are due to pneumonia. To study the clinical effectiveness of co-trimoxazole versus amoxicillin in the treatment of non-severe pneumonia, as defined by WHO, in children in the age group of 02 months to 5 years. Randomized Control Trial study was conducted in out patient department of a large tertiary care hospital after taking consent from parents and ethical committee clearance. Methods: Children in study group were treated with amoxicillin (40 mg/kg/day in 3 divided doses) and those in control group were treated with co-trimoxazole (8 mg/kg/day of trimethoprim in 2 divided doses). All cases were reviewed on second and fifth day. The effectiveness and therapy failure were decided on the basis of clinical, radiological and complete blood count results. Results: Two hundred and four cases of non severe pneumonia were studied. All cases were diagnosed on the basis of clinical criteria, as defined by WHO. Treatment failure was seen in 8.09% cases with amoxicillin and 39.05% cases with co-trimoxazole. Cost of one complete course with amoxicillin was 2.3 times higher than with co-trimoxazole. Compliance of therapy to co-trimoxazole (90.47%) was better than to amoxicillin (83.84%). Conclusions: The response to treatment with amoxicillin is faster, however, compliance is slightly poorer and cost of treatment high. In order to improve the compliance, better counseling and more studies are required to ascertain the efficacy of amoxicillin in higher dosage over a shorter period of time.

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