Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Clinical Effectiveness of Oral Amoxicillin for Treatment of Child-hood Non-Severe Pneumonia at Primary Health Centers, Sana’a Governorate Yemen – 2021: A Randomized Controlled Trail

Version 1 : Received: 6 May 2023 / Approved: 9 May 2023 / Online: 9 May 2023 (04:12:01 CEST)

How to cite: Al-Sakkaf, E.; Al-Jamrah, K.; Al-Hadi, A.; Al Amad, M.; Ghaleb, Y. Clinical Effectiveness of Oral Amoxicillin for Treatment of Child-hood Non-Severe Pneumonia at Primary Health Centers, Sana’a Governorate Yemen – 2021: A Randomized Controlled Trail. Preprints 2023, 2023050559. https://doi.org/10.20944/preprints202305.0559.v1 Al-Sakkaf, E.; Al-Jamrah, K.; Al-Hadi, A.; Al Amad, M.; Ghaleb, Y. Clinical Effectiveness of Oral Amoxicillin for Treatment of Child-hood Non-Severe Pneumonia at Primary Health Centers, Sana’a Governorate Yemen – 2021: A Randomized Controlled Trail. Preprints 2023, 2023050559. https://doi.org/10.20944/preprints202305.0559.v1

Abstract

Pneumonia kills over two million children under-age of five every year. Oral amoxicillin was recommended by WHO as the first drug of choice for treatment of non-severe pneumonia. The study aimed to determine the clinical failure rate of amoxycillin for the treatment of childhood non-severe pneumonia at Primary Health Care Centers (PHCCs). A randomized controlled multicenter-trial study was conducted in Sana’a. IMCI strategy was used to enrollments the cases where randomly allocated to receive amoxicillin or co-trimoxazole orally for five days. Multivariate logistic regression was used for identified risk factors associated with clinical failure. A total of 254 children were enrolled, of whom 128 cases were treated with amoxicillin while 126 with co-trimoxazole. The clinical failure for amoxicillin was significantly more than co-trimoxazole (30% vs 10%) p value > 0.001. the most risk factor which significantly associated to amoxicillin failure were pre-infection in the last 6 months, while abnormal CBC and literate mothers were associated with clinical failure of co-trimoxazole (p value > 0.05). The use of co-trimoxazole as an alternative to amoxicillin for the treatment of non-severe pneumonia in the PHCCs and conducting further studies to determine the appropriate antibiotic as the first line of defense are recommended.

Keywords

Pneumonia; Amoxicillin; Randomized Trial; Antimicrobial-Resistance.

Subject

Public Health and Healthcare, Primary Health Care

Comments (6)

Comment 1
Received: 22 September 2023
Commenter:
The commenter has declared there is no conflict of interests.
Comment: I think the high rate of amoxicillin failure in treating non severe pneumonia is the abuse of antibiotic, exposure of AB while the infection is viral increases the rate of resistance, which make the physician select another AB to kill the bacteria. In other hand we have to restrict the use of AB and leave it for cases who really need it, so the effectiveness of AB will not disappear.
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Comment 2
Received: 24 September 2023
Commenter:
The commenter has declared there is no conflict of interests.
Comment:
  • textexellant topic to publish dute to increase antibiotics using in last few years
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    Comment 3
    Received: 24 September 2023
    Commenter:
    The commenter has declared there is no conflict of interests.
    Comment: thank you Dr.Ehab for this study.
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    Comment 4
    Received: 26 September 2023
    Commenter:
    The commenter has declared there is no conflict of interests.
    Comment: Excellent Study Dr. Ehab

    Your research on "Clinical Effectiveness of Oral Amoxicillin for Treatment of Childhood Non-Severe Pneumonia at Primary Health Centers, Sana'a Governorate Yemen - 2021" is truly remarkable. Your dedication to addressing a crucial health issue is commendable.

    The randomized controlled trial design adds a robust scientific foundation to your findings, and the clarity of presentation makes it accessible to a wide audience.

    Moreover, your commitment to sharing this research with the world through platforms like Preprints.org and social media demonstrates your passion for advancing public health.

    I'm confident that your study will not only contribute significantly to the field but also inspire others in epidemiology and public health. Keep up the outstanding work
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    Comment 5
    Received: 26 September 2023
    Commenter:
    The commenter has declared there is no conflict of interests.
    Comment: We need studies like this, to reduce the indiscriminate use of antibiotics.
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    Comment 6
    Received: 9 October 2023
    Commenter:
    The commenter has declared there is no conflict of interests.
    Comment: Wonderful work and deserves praise. The researcher team has highlighted an important problem in the Yemeni health sector. Good luck
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