Objective
To compare the effectiveness of intravenous penicillin vs clindamycin for the treatment of aspiration pneumonia.
Design
A double-blind, randomized controlled trial.
Setting
A tertiary care pediatric hospital.
Patients
We enrolled 42 children, aged 6 months to 18 years, who were admitted to the hospital for the treatment of aspiration pneumonia. All of the children had underlying conditions that predispose to aspiration.
Intervention
The patients were randomly assigned to receive intravenous penicillin G sodium, 250 000 U/kg every 24 hours, or intravenous clindamycin phosphate, 30 mg/kg every 24 hours.
Main Outcome Measure
The primary outcome measure was "time to ready for discharge" from the hospital.
Results
In an effectiveness (intention to treat) analysis, the median time (interquartile range) to ready for discharge from the hospital was 4.9 days (range, 2.8-6.5 days) in the penicillin-treated group and 3.4 days (range, 2.3-6.8 days) in the clindamycin-treated group (P=.66). Results were not markedly altered when adjusted for the age difference of the groups or in the efficacy analysis (after the exclusion of 9 patients who withdrew from the trial). Rates for readmission to the hospital were similar in the 2 groups.
Conclusion
Penicillin and clindamycin seem to be equally effective for the treatment of aspiration pneumonia in children hospitalized for this illness.
Arch Pediatr Adolesc Med. 1997;151:701-704
