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Pneumonia in South Africa
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After a WHO consultative meeting in Harare in 2003 it was recommended that children admitted to hospital with severe pneumonia in HIV endemic areas should be treated with benzylpenicillin or ampicillin plus gentamycin. Infants should also receive high-dose trimethoprim-sulfamethoxazole because of the risk of Pneumocystis jirovecii (previously P carinii) pneumonia. Now a study in Durban (Lisa M McNally and colleagues. Lancet 2007;369:1440–51[CrossRef][Medline] ; see also Comment, ibid: 1409–10) has shown that a high proportion of HIV infected infants, and of the HIV-free infants of HIV infected mothers, did not respond adequately to this treatment.
The study was carried out in 2002, when the antenatal HIV-1 seroprevalence rate was 36.5% and antiretroviral treatment was not available in public health sector care. It included 358 children aged 1–59 months (260 <1 year) with severe or very severe pneumonia as defined by the WHO. HIV infection
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