Clinical application of the rapid pneumococcal urinary antigen test in the treatment of severe pneumonia in children.

摘要

BACKGROUND AND PURPOSE: To evaluate the efficacy of the pneumococcal urinary antigen test (PUAT) in severe pediatric pneumonia. METHODS: The study enrolled 245 pediatric patients with severe pneumonia. Patients were divided into four groups; groups 1 and 2 received PUAT, while groups 3 and 4 did not. Additionally, PUAT-positive group 1 patients were treated with penicillin, while PUAT-negative patients received ampicillin-sulbactam or cefuroxime. Group 2 patients were treated empirically without following the group 1 protocol. Group 3 patients were treated following the guideline of the Infectious Diseases Society of Taiwan (IDST), and group 4 patients were treated empirically without following the IDST guideline. Treatment was assessed by the duration of fever. RESULTS: Treatment was most effective for group 1 and least effective for group 4. Group 2 treatment was superior to group 3 treatment. Multivariate regression analysis of groups 1 and 2 revealed that the use of PUAT (groups 1 and 2) was associated with superior response in comparison with group 4. CONCLUSION: Application of PUAT and adequate antimicrobial treatments in the initial stage for pediatric patients with severe pneumonia resulted in improved outcome as assessed by shortening of the duration of fever.