Clinical application of the rapid pneumococcal urinary antigen test in the treatment of severe pneumonia in children
Huey-Fung Cheong, Luo-Ping Ger, Ming-Ting Wu, Chih-Pei Sun, Kai-Sheng Hsieh, Yung-Ching Liu, Ming-Fang Cheng
Department of Pediatrics, Pingtung Christian Hospital, Pingtung; Departments of Pediatrics and Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung; School of Medicine, National Yang-Ming University, Taipei; and Departments of 5Radiology and 6Microbiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
Received: May 8, 2006 Revised: July 20, 2006 Accepted: August 30, 2006
Background and purpose:
To evaluate the efficacy of the pneumococcal urinary antigen test (PUAT) in severe pediatric pneumonia.
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.
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.
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.
Antigens, bacterial; Child; Pneumonia, pneumococcal; Predictive value of tests; Streptococcus pneumoniae
J Microbiol Immunol Infect. 2008;41:41-47.