Predictors of treatment failure in severe pneumonia treated with Ampicillin in tertiary care center


  • Lakshmi M. Department of Pediatrics, Bangalore Medical College and Research Institute, Bangalore, Karnataka,
  • Manu M. A. Department of Pediatrics, Bangalore Medical College and Research Institute, Bangalore, Karnataka,
  • Kalpana R. Y. Department of Pediatrics, Bangalore Medical College and Research Institute, Bangalore, Karnataka,
  • Sarala Sabapathy Department of Pediatrics, Bangalore Medical College and Research Institute, Bangalore, Karnataka,
  • Rekha T. D. Department of Pediatrics, Bangalore Medical College and Research Institute, Bangalore, Karnataka,



Ampicillin, Anemia, Hypoxia, Immunization, Moderate acute malnutrition, Pneumonia, Rickets, Severe treatment failure


Background: Pneumonia affects 156 million children under five years every year and is the leading cause of mortality in this age group. It emphasizes the need to identify high risk factors for Treatment Failure so as to treat them aggressively. The objective of this study was to assess factors influencing treatment failure in severe pneumonia treated with Ampicillin.

Methods: Prospective observational study, in which 235 children with severe pneumonia between 2 months to 60 months were enrolled and started with intravenous Ampicillin as per WHO protocol. If no clinical improvement was seen after 48 hours, it was taken as treatment failure and managed accordingly.

Results: Among 235 children, 43(18.2%) did not respond to Ampicillin. Among treatment failure cases males were 20 (46.5%) and females were 23 (53.6%). All the following parameters were statistically significant(p<0.05). Majority of 23(53.4%) were between 2 to 12 months. 13(30.2%) were incompletely immunized. MAM were 23(53.4%) and 22(51.1%) cases had signs of Rickets. 34(79.1%) had Anemia out of which 22(64%) had moderate anemia. 39(90.6%) children had fever and hypoxia at admission.

Conclusions: Infancy, malnutrition, severity of anemia, rickets, lack of immunization, hypoxia at baseline were significant predictors of treatment failure in severe pneumonia. Strengthening immunization and improving nutritional status may improve the outcome. Children with above risk factors require vigilant monitoring.


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