All cases, aged 2 months to 5 years diagnosed as severe pneumonia according to A.R.I. programme during study year March 1995 to March 1996 were included in the study. The purpose was to determine a) clinical features on presentation, b) correlation between clinical and radiological diagnosis and c) response to treatment with chloramphenicol. Among total admissions of 1623 cases, 24.32% were admitted with respiratory complaints. 71 cases were classified as severe pneumonia according to ARI programme, and treated with chloramphenicol, 3 cases were excluded from the study as they left within 48 hrs. Out of remaining 68 children, 41 (60.29%) were below I year, 15 were 1-3 yrs and 12 cases were 3-5 yrs old. MY ratio was 1.7: I. In 45.6% of cases the duration of complaints was less than 48 hrs, while in 48.6% it was 35 days. Only 25 cases i.e. 36.76% had radiological changes consistent with pneumonia out of which 7 (10.29%) had lobar pneumonia. 61/68 cases i.e. 89.70% responded to treatment with chloramphenicol with clinical response within 48 hrs but 22/61 cases needed treatment for 7 days due to persistent clinical signs. One child expired within 24 hrs, (mortality of 1.47%) and treatment was changed in 6 cases (8.82%) due to lack of response in 48 hrs. This study confirms that chloramphenical is an effective treatment for most cases of severe pneumonia.
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