A RANDOMIZED CONTROLLED TRIAL OF PENICILLIN VS CLINDAMYCIN FOR THE TREATMENT OF ASPIRATION PNEUMONIA IN CHILDREN

Objective: To compare the effectiveness of intravenous penicillin vs c lindamycin for the treatment of aspiration pneumonia. Design: A double -blind, randomized controlled trial. Setting: A tertiary care pediatri c hospital. Patients: We enrolled 42 children, aged 6 months to 18 yea rs, who were admitted to the hospital for the treatment of aspiration pneumonia. All of the children had underlying conditions that predispo se 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 O utcome Measure: The primary outcome measure was ''time to ready for di scharge'' from the hospital. Results: In an effectiveness (intention t o 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 cli ndamycin-treated group (P=.66). Results were not markedly altered when adjusted for the age difference of the groups or in the efficacy anal ysis (after the exclusion of 9 patients who withdrew from the trial). Rates for readmission to the hospital were similar in the 2 groups. Co nclusion: Penicillin and clindamycin seem to be equally effective for the treatment of aspiration pneumonia in children hospitalized for thi s illness.