14 Patients who were discharged against medical advice, transferred to other health facilities, or
more recently to the PICU, or patients whose data records were incomplete were excluded. All children had one or more of the following signs and symptoms associated with radiological condensation abnormalities: selleck chemical cough, high respiratory rate, sub costal depression, cyanosis, flaring of the nostrils, moaning, irritability/lethargy, torpor, and shock. The variable of interest was death (mortality) in relation to the type of antibiotic used in the treatment. The following variables were studied: age (younger than 1 year, between 1 and 5 years, and 5 years or older; also categorized as as younger than five years or five years and older); gender; hospitalization time (categorized as less than 14 days or 14 days or more; or as zero to six, seven to 14, and more than 14 days); severe illness at admission (presence of at least one of the following findings concomitant with CAP classified as severe according to the WHO criteria: signs of sepsis, respiratory failure, cyanosis, flaring of the nostrils, moaning, torpor/coma, irritability/torpor,
or shock);8 and 14 click here initial treatment with antibiotics (penicillin or others);nutritional status, which considered the 2002 weight/age criterion of the Brazilian Ministry of Health15 to classify the child as malnourished (underweight or very low weight for age) and normal weight; comorbidity (present when the child had any concomitant disease, usually chronic, undergoing treatment at the IPPMG, such as: wheezing, persistent asthma, recurrent pneumonia, chronic pneumonia, bronchopulmonary
dysplasia, diabetes, sickle cell anemia, AIDS, systemic rheumatoid arthritis, genetic syndrome, encephalopathy, heart Erlotinib concentration disease, among other chronic diseases and associations between them); pleural effusion (radiographic evidence); and type of agent (isolated from the analysis of material assessed for direct examination and culture sputum, blood, pleural fluid, bronchoalveolar wash/aspirate). Chest X-rays were analyzed by a radiologist at the institution, adopting the standard proposed by the WHO.16 Data were collected systematically, daily, from the first day of admission to hospital discharge, by postgraduate students of the Department of Pediatric Pulmonology of the IPPMG, trained for such assignment and under the supervision of professors of the service. The forms prepared for this purpose were previously tested and periodically compared with data from medical records, by researchers other than those responsible for the original collection. The protocol and data collection system were implemented and tested in a pilot project. Data were transferred to an electronic database and analyzed using Stata software, release 7.0.