Study on safety and efficacy of Cephalosporins with macrolides in the treatment of lower respiratory tract infection in a tertiary care teaching hospital

Abstract Background Lower respiratory tract infection (LRTI) is one of the major causes of mortality in children with estimated 1 million deaths every year. Hyponatremia is the most common electrolyte abnormality seen in LRTI. Objective To find association of hyponatremia (serum sodium<135meq/l) with severe LRTI. Design Prospective cross sectional study Settings Pediatric Emergency, Ward and Pediatric Intensive Care Unit of Tribhuvan University Teaching Hospital(TUTH) Subjects Children between 2 months to 16 years presenting with cough for less than 3 weeks, fast breathing and chest indrawing. Methods Children between 2 month to 16 years of age having cough, fast breathing and chest indrawing admitted in emergency, ward or PICU of TUTH were screened and among them, children having pediatric respiratory severity score of 4-5 were enrolled in the study. Serum sodium was sent during admission and collected within 2 hours. Daily follow up was done to find need of respiratory support, duration to resolve hypoxia, total duration in hospital and final outcome of patient. Statistical test applied were Chi-square test and Fisher exact test. Results 47.5% of study population had hyponatremia, of whom 65.79% had mild hyponatremia 26.31% had moderate and 7.89%had severe hyponatremia. Association of hyponatremia with need of non rebreathing face mask (p=0.001), ventilatio r (p=0.009), duration of hospital stay (p=0.047) were significant. The study also found the association of severity of hyponatremia with need of non rebreathing facemask (p=0.001),ventilator (p=0.01), outcome (p=0.001), duration of stay (0.002). Mean time to resolve hypoxia in children with hyponatremia (4.5 days) was longer compared to normal sodium (2.58 days). Four patients died during the study period and all of them had hyponatremia.

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Assessment of Malnutrition as a Risk Factor for Acute Lower Respiratory Tract Infection in Children under 5 yr Age at a Tertiary Hospital

Journal of College of Medical Sciences-Nepal ◽

10.3126/jcmsn.v15i2.21840 ◽

2019 ◽

Vol 15 (2) ◽

pp. 107-111

Author(s):

Sunil Raja Manandhar ◽

Petter Thorell ◽

Ida Kallur ◽

Sunil Kumar Joshi

Keyword(s):

Risk Factor ◽

Tract Infection ◽

Respiratory Tract ◽

Respiratory Tract Infection ◽

Lower Respiratory Tract Infection ◽

Teaching Hospital ◽

Lower Respiratory Tract ◽

College Teaching ◽

Health Concern ◽

Medical College

Background: Malnutrition among young children is becoming a major public health concern in low income countries like Nepal where under nutrition remains one of the primary causes of ill health. Acute lower respiratory tract infection (ALRTI) and malnutrition in children are associated with morbidity and mortality in developing countries.Objective of this study was to assess ALRTI as a risk factor for malnutrition in children at Kathmandu Medical College Teaching Hospital. Methods: This was a cross-sectional study con-ducted at Kathmandu Medical College Teaching Hospital over 5 months duration (August - December 2017). Under 5 yrs children diagnosed as ALRTI were taken and healthy children from same age group attending the immunization clinic were the controls. Anthropometric measurements were measured and stunting and wasting were described according to the WHO classification of malnutrition. Data were analyzed using SPSS version 18. Statistical analyses were done in the form of frequency, mean and cross tabulation. Chi-Square test was used to assess the association of ALRTI with malnutrition. P value <0.05 was considered to be sig-nificant. Results: A total of 200 children were included in this study. Children with ALRTI (n = 90) and con-trols (n =110) were analyzed. Male participants were observed more in both groups (60% and 68%). Wasting and stunting were observed more in ALRTI group than in control groups. Conclusions: This study showed there was a relation between ALRTI and malnutrition in children. So, this study has identified malnutrition as one of the major risk factor for ALRTI in under 5 yrs children.

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Hyponatremia as a Predictor of Adverse Outcome in Children With Severe Lower Respiratory Tract Infection in Tribhuvan University Teaching Hospital (Tuth), Nepal

10.21203/rs.2.20441/v1 ◽

2020 ◽

Author(s):

Machhindra Lamichhane ◽

Laxman Shrestha ◽

Luna Bajracharya ◽

Archana Bagale

Keyword(s):

Tract Infection ◽

Respiratory Tract ◽

Respiratory Tract Infection ◽

Lower Respiratory Tract Infection ◽

Teaching Hospital ◽

Serum Sodium ◽

Lower Respiratory Tract ◽

Face Mask ◽

University Teaching ◽

Emergency Ward

Abstract Introduction: Lower respiratory tract infection (LRTI) is one of the major causes of mortality in children with estimated 1 million deaths every year. Hyponatremia is the most common electrolyte abnormality seen in LRTI. Objective: To find association of hyponatremia (serum sodium<135meq/l) with severe LRTI. Design: Prospective cross sectional study Settings: Pediatric Emergency, Ward and Pediatric Intensive Care Unit of Tribhuvan University Teaching Hospital(TUTH) Subjects: Children between 2 months to 16 years presenting with cough for less than 3 weeks, fast breathing and chest indrawing. Methods: Children between 2 month to 16 years of age having cough, fast breathing and chest indrawing admitted in emergency, ward or PICU of TUTH were screened and among them, children having pediatric respiratory severity score of 4-5 were enrolled in the study. Serum sodium was sent during admission and collected within 2 hours. Daily follow up was done to find need of respiratory support, duration to resolve hypoxia, total duration in hospital and final outcome of patient. Statistical test applied were Chi-square test and Fisher exact test. Results: 47.5% of study population had hyponatremia, of whom 65.79% had mild hyponatremia 26.31% had moderate and 7.89%had severe hyponatremia. Association of hyponatremia with need of non rebreathing face mask (p=0.001), ventilatio r (p=0.009), duration of hospital stay (p=0.047) were significant. The study also found the association of severity of hyponatremia with need of non rebreathing facemask (p=0.001),ventilator (p=0.01), outcome (p=0.001), duration of stay (0.002). Mean time to resolve hypoxia in children with hyponatremia (4.5 days) was longer compared to normal sodium (2.58 days). Four patients died during the study period and all of them had hyponatremia. Conclusion- Association of hyponaremia and severity of hyponatremia in severe LRTI with need of non-rebreathing face mask, ventilatior, outcome, duration of stay was significant.

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Thrombocytosis: a predictor of severity in children with lower respiratory tract infection

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20213725 ◽

2021 ◽

Vol 8 (10) ◽

pp. 1658

Author(s):

Chandrakala P. ◽

Vinutha Patil ◽

Kavya V. N. ◽

Sushmitha .

Keyword(s):

Platelet Count ◽

Tract Infection ◽

Respiratory Tract ◽

Respiratory Distress ◽

Respiratory Tract Infection ◽

Lower Respiratory Tract Infection ◽

Lower Respiratory Tract ◽

Tertiary Care ◽

Severe Pneumonia ◽

Care Hospital

Background: Community acquired pneumonia remains a significant cause of morbidity and mortality due to infection all over the world. Thrombocytes are known to be an essential part of immune response to various infectious agents. Platelet count elevated more than normal is often sign of severe pneumonia according to various studies.Methods: This is a retrospective study conducted in Kempegowda Institute of Medical Science, a tertiary care hospital in Bangalore with a study duration of 1 year. All children were classified into two groups based on platelet count that is with thrombocytosis and without thrombocytosis. Respiratory distress was defined as presence of tachypnoea, chest retractions, oxygen saturation <94% in room air. Children with respiratory distress were classified as severe pneumonia and those with no respiratory distress as non-severe pneumonia.Results: A total of 213 children were admitted with lower respiratory tract infection of which 35 children were excluded based on exclusion criteria. Of these 178 children 142 (80%) belonged to non-severe pneumonia group and 36 (20%) belonged to severe pneumonia group. Thrombocytosis is found in 31 (17%) children, 147 (82%) children had platelet count less than 4.5 lakhs/cu mm. Of these children with thrombocytosis 13 (42%) had non severe pneumonia and 18 (58%) had severe pneumonia. The p<0.0000001 which showed statistical significance, that is thrombocytosis was significantly associated with severity of pneumonia.Conclusions: Thrombocytosis can be considered as a marker of severity of pneumonia in day-to-day practice.

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Epidemiology of Hyponatraemia among Elderly Patients with Lower Respiratory Tract Infection

Bangladesh Journal of Medicine ◽

10.3329/bjm.v31i1.44748 ◽

2019 ◽

Vol 31 (1) ◽

pp. 13-17

Author(s):

B Raju ◽

A Rishab ◽

K Vikram ◽

T Vaibhav ◽

T Sharat ◽

...

Keyword(s):

Tract Infection ◽

Respiratory Tract ◽

Elderly Patients ◽

Respiratory Tract Infection ◽

Lower Respiratory Tract Infection ◽

Lower Respiratory Tract ◽

Tertiary Care ◽

Age Group ◽

Cross Sectional ◽

Tract Infections

Background: Decrease in serum sodium concentration is frequent observation among hospitalised elderly patients. The common causes for hyponatremia are degenerative physiology, dehydration, medications and infections. Hence the present study was undertaken to know the extent of hyponatremia among elderly with Lower Respiratory Tract Infections. Objectives: The present study was undertaken to assess the prevalence of hyponatremia in lower respiratory tract infection among geriatric age group and to determine the association between severity of hyponatraemia and LRTI. Methods: This was hospital based cross sectional study carried out in the Department of General Medicine of a tertiary care teaching hospital situated in north Karnataka, India during November 2016 to May 2018. 100 elderly patients (age e” 60 years) with history of cough for more than four to five days, clinical findings and X-ray findings suggestive of LRTI, were selected for the study. Results: In the present study 59% comprised of male whereas females constituted 41%. The prevalence of hyponatraemia among elderly patients with LRTI was 45%. The most common cause of hyponatraemia was GI loss (vomiting) 53.33%, Euvolemic hyponatramia 51.11%. The mean age was 69.99±8.44 years. Most of the patients were aged between 61 to 70 years. .Hyponatraemia was not associated with sex, age and type of LRTI. Duration of hospital stay was significantly longer in patients with hyponatraemia compared to those who did not develop hyponatraemia. Conclusion: Hyponatraemia among elderly individuals with LRTI is higher as compared to other age group hence leading to prolonged duration of hospitalisation. Bangladesh J Medicine Jan 2020; 31(1) : 13-17

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Correlation of weight and hypoxemia in children aged between six months to five years with acute lower respiratory tract infection in a tertiary care hospital

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20203162 ◽

2020 ◽

Vol 7 (8) ◽

pp. 1711

Author(s):

Karthikeyan S. ◽

Adarsh E.

Keyword(s):

Tract Infection ◽

Respiratory Tract ◽

Respiratory Tract Infection ◽

Lower Respiratory Tract Infection ◽

Lower Respiratory Tract ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

P Value ◽

Care Hospital ◽

Weight For Age

Background: Acute respiratory infections (ARIs) are the leading cause of death among children less than 5 years in India. Poverty and malnutrition underlie both the high incidence and deaths of young children from pneumonia in SEAR countries.Methods: A hospital based prospective observational study was conducted in a tertiary care hospital. A total of 200 children admitted with signs of ALRI were included in the study. A portable oximeter was used to measure oxygen saturation with an appropriately sized sensor on the finger or the toe. Weight was recorded on a standardized digital weighing scale and plotted on standard WHO weight for age chart. Chi-square test was used to test the significance.Results: Out of 200 children studied hypoxemia was present in 90 children with a percentage of 45% and absent in 110 children with a percentage of 55%. Out of 90 children who had hypoxemia, 40 children had weight less than 3rd centile. Out 110 children who had did not have hypoxemia, only 24 children had weight less than 3rd centile. It was observed that children with Weight for age less than 3rd centile according to standard WHO charts had higher incidence of hypoxemia. This correlation was statistically significant at p value of 0.001.Conclusions: Based on the results of this study hypoxemia is widely prevalent in children aged between six months to five years presenting with acute lower respiratory tract infection. There was significant correlation with weight and hypoxemia in children aged between six months to five years with acute lower respiratory tract infection.

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Prevalence of lower respiratory tract infection in tertiary care hospital, Thane

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20213733 ◽

2021 ◽

Vol 8 (10) ◽

pp. 1700

Author(s):

Shrikant Joshi ◽

Kamil Shaikh ◽

Vrushali V. Kulkarni

Keyword(s):

Risk Factors ◽

Family History ◽

Tract Infection ◽

Respiratory Tract ◽

Respiratory Tract Infection ◽

Lower Respiratory Tract Infection ◽

Lower Respiratory Tract ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital

Background: World health organization (WHO) predicted lower respiratory tract infections (LRTI) as primary cause of mortality world-wide. The present study was undertaken to know the various types of LRTI in children <5 years of age and analyze factors influencing the morbidity and mortality of those cases.Methods: Prospective cross-sectional study for 100 infected children with LRTI was conducted in a tertiary care hospital of metropolitan city. Demographic, clinical history and examination, necessary investigations were performed and followed regularly for desired outcome.Results: 51% children were in the age-group of 1 to 5 years who reported acute lower respiratory tract infection (ALRTI) and 49% were below 1 year age. The study reported LTRI incidence in 63% male and 37% female children whereas the family history of incidence of LRTI was present in 18% cases. Fever, cough and retraction complaints were the prominent symptoms. Hyperinflation was the major finding in chest X-ray. Streptococcus pneumoniae was the common bacterial pathogens isolated. Bronchiolitis was the commonest cause (39%) followed by lobar pneumonia (37%).Conclusions: Various types of clinical presentations, risk factors and types of LRTI in children less than 5 years of age were studied. A result of this study will be useful to understand the etiology and bacterial pathogens in management of clinical outcome. Modifiable risk factors for LRTI like family history, past history, immunization status, and malnutrition can be tackled through effective health education of the community, leading to a healthy society.

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