The prognosis of pneumonia in infancy and childhood.

The use of the sulphonamides and penicillin in the therapy of pneumonia and bronchopneumonia in children has considerably altered the prognosis in these diseases. Although there are reports on the results of treatment with various sulphonamides, there are only a few published studies on the response to treatment with penicillin alone or with penicillin and sulphonamides combined. It was felt, therefore, that a survey of the results of treatment of pneumonia during the past three years at two children's hospitals might be of value in assessing the therapeutic efficency of methods currently employed. The records of all pneumonia cases admitted to the Royal Manchester Children's Hospital and to the Duchess of York Babies Hospital during 1946, 1947, and 1948 have been examined. The clinical diagnosis in all cases included in this study was confirmed radiologically and, in the event of death, by necropsy. Two hundred and fourteen cases were thus surveyed. The overall mortality in this series (Tables 1 and 2) with all forms of treatment was 170o (33 of 194 cases). This rather high mortality is accounted for by the large number of infants under six months of age. Figures given by Scandinavian authors varied from 22%o (Friedlander, 1931) to 140o (Lichtenstein, 1939; Vilen, 1942), while in this country mortality figures of 170o in 1937 (Gaisford, 1940) and 180o in 1939 (King Lewis, 1944) were recorded. More recently a fatality rate of 28O" from bronchitis and pneumonia in infants under one year of age for the period 1946-1948 was given by Smellie (1949). In the present series, excluding the cases under