Antibiotic use and outcomes among children hospitalized with suspected pneumonia

Autor: Jillian M. Cotter, Todd A. Florin, Angela Moss, Krithika Suresh, Nidhya Navanandan, Sriram Ramgopal, Samir S. Shah, Richard Ruddy, Allison Kempe, Lilliam Ambroggio
Rok vydání: 2022
Předmět:
Zdroj: Journal of Hospital Medicine. 17:975-983
ISSN: 1553-5606
1553-5592
Popis: Although viral etiologies predominate, antibiotics are frequently prescribed for community-acquired pneumonia (CAP).We evaluated the association between antibiotic use and outcomes among children hospitalized with suspected CAP.We performed a secondary analysis of a prospective cohort of children hospitalized with suspected CAP.The exposure was the receipt of antibiotics in the emergency department (ED).Clinical outcomes included length of stay (LOS), care escalation, postdischarge treatment failure, 30-day ED revisit, and quality-of-life (QoL) measures from a follow-up survey 7-15 days post discharge. To minimize confounding by indication (e.g., radiographic CAP), we performed inverse probability treatment weighting with propensity analyses.Among 523 children, 66% were5 years, 88% were febrile, 55% had radiographic CAP, and 55% received ED antibiotics. The median LOS was 41 h (IQR: 25, 54). After propensity analyses, there were no differences in LOS, escalated care, treatment failure, or revisits between children who received antibiotics and those who did not. Seventy-one percent of patients completed follow-up surveys after discharge. Among 16% of patients with fevers after discharge, the median fever duration was 2 days, and those who received antibiotics had a 37% decrease in the mean number of days with fever (95% confidence interval: 20% and 51%). We found no statistical differences in other QoL measures.
Databáze: OpenAIRE
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