, Volume 47, Supplement 3, pp 43–51 | Cite as

Parenteral-Oral Switch in the Management of Paediatric Pneumonia

  • R. Dagan
  • G. Syrogiannopoulos
  • S. Ashkenazi
  • D. Engelhard
  • M. Einhorn
  • M. Gatzola-Karavelli
  • I. Shalit
  • J. Amir


In phase I of a 2-phase study, 56 evaluable children (0.8 to 5 years) with lobar or segmental pneumonia received intravenous or intramuscular ceftriaxone 50 mg/kg/day for 2 days followed by oral cefetamet pivoxil 20 mg/kg/day in 2 divided doses to complete 7 days of treatment. All patients achieved a clinical cure.

In phase II, a randomised open multicentre study, 62 children with pneumonia received an identical regimen to phase I (arm A), and 59 children received ceftriaxone 50 mg/kg/day for 1 day followed by 6 days’ treatment with cefetamet pivoxil 20 mg/kg/day (arm B). Patients from phase I and arm A were combined giving a total of 118 evaluable patients in arm A.

At the end of treatment, 100% of patients in arm A and 96% in arm B achieved a clinical cure; cure was maintained in 99 and 98% of patients, respectively. Two (4%) patients in arm B failed therapy; in both cases, factors other than treatment failure may have accounted for the poor response.

11 and 12% of patients in treatment arms A and B, respectively, experienced adverse events; gastrointestinal events (nausea and/or vomiting) were reported in 9 and 8% of patients, respectively.

In conclusion, 1 or 2 days’ treatment with parenteral ceftriaxone before switching to oral cefetamet pivoxil was safe and effective in the treatment of childhood pneumonia. Therefore, parenteral-oral switch is a feasible treatment option in the treatment of serious paediatric community-acquired pneumonia.


Ceftriaxone Chest Roentgenogram Cefetamet Acute Lower Respiratory Tract Infection Oral Cephalosporin 
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Copyright information

© Adis International Limited 1994

Authors and Affiliations

  • R. Dagan
    • 1
  • G. Syrogiannopoulos
    • 2
  • S. Ashkenazi
    • 3
  • D. Engelhard
    • 4
  • M. Einhorn
    • 5
  • M. Gatzola-Karavelli
    • 5
  • I. Shalit
    • 6
  • J. Amir
    • 7
  1. 1.Pediatrie Infectious Disease UnitSoroka University Medical Center, Ben-Gurion University of the NegevBeer-ShevaIsrael
  2. 2.Department of PediatricsUniversity of Patras, School of MedicinePatrasGreece
  3. 3.Belinson Medical CenterPetach TikvahIsrael
  4. 4.Hadassah University Medical CenterJerusalemIsrael
  5. 5.Department of Pediatric MedicineAHEPA University HospitalThessalonikiGreece
  6. 6.Ichilov Medical CenterTel AvivIsrael
  7. 7.Hasharon Medical CenterPetach TikvahIsrael

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