The Influence of National Guidelines on the Management of Community-Acquired Pneumonia in Children. Do Pediatricians Follow the Recommendations?

2019 ◽  
pp. 103-110 ◽  
Author(s):  
Grażyna Kraj ◽  
Joanna Peradzyńska ◽  
Julita Chądzyńska ◽  
Marek Kulus ◽  
Krystian Wołoszyn ◽  
...  
Keyword(s):  
Community Acquired Pneumonia ◽  
National Guidelines

scholarly journals The Association of Antibiotic Duration With Successful Treatment of Community-Acquired Pneumonia in Children

2020 ◽  
Author(s):  
Rebecca G Same ◽  
Joe Amoah ◽  
Alice J Hsu ◽  
Adam L Hersh ◽  
Daniel J Sklansky ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Treatment Failure ◽  
Propensity Score Analysis ◽  
Day Treatment ◽  
Hospital Readmissions ◽  
Community Acquired Pneumonia ◽  
Emergency Department Visits ◽  
Johns Hopkins Hospital ◽  
National Guidelines ◽  
Short Course

Abstract Background National guidelines recommend 10 days of antibiotics for children with community-acquired pneumonia (CAP), acknowledging that the outcomes of children hospitalized with CAP who receive shorter durations of therapy have not been evaluated. Methods We conducted a comparative effectiveness study of children aged ≥6 months hospitalized at The Johns Hopkins Hospital who received short-course (5–7 days) vs prolonged-course (8–14 days) antibiotic therapy for uncomplicated CAP between 2012 and 2018 using an inverse probability of treatment weighted propensity score analysis. Inclusion was limited to children with clinical and radiographic criteria consistent with CAP, as adjudicated by 2 infectious diseases physicians. Children with tracheostomies; healthcare-associated, hospital-acquired, or ventilator-associated pneumonia; loculated or moderate to large pleural effusion or pulmonary abscess; intensive care unit stay >48 hours; cystic fibrosis/bronchiectasis; severe immunosuppression; or unusual pathogens were excluded. The primary outcome was treatment failure, a composite of unanticipated emergency department visits, outpatient visits, hospital readmissions, or death (all determined to be likely attributable to bacterial pneumonia) within 30 days after completing antibiotic therapy. Results Four hundred and thirty-nine patients met eligibility criteria; 168 (38%) patients received short-course therapy (median, 6 days) and 271 (62%) received prolonged-course therapy (median, 10 days). Four percent of children experienced treatment failure, with no differences observed between patients who received short-course vs prolonged-course antibiotic therapy (odds ratio, 0.48; 95% confidence interval, .18–1.30). Conclusions A short course of antibiotic therapy (approximately 5 days) does not increase the odds of 30-day treatment failure compared with longer courses for hospitalized children with uncomplicated CAP.

Adherence With National Guidelines in Hospitalized Patients With Community-acquired Pneumonia: Results From the CAPO Study in Venezuela

2015 ◽  
Vol 51 (4) ◽  
pp. 163-168
Author(s):  
Gur Levy ◽  
Mario Perez ◽  
Benito Rodríguez ◽  
Ana Hernández Voth ◽  
Jorge Perez ◽  
...  
Keyword(s):  
Community Acquired Pneumonia ◽  
Hospitalized Patients ◽  
National Guidelines

scholarly journals Current Antibiotic Treatment and Outcome for Lower Respiratory Tract Infections

1998 ◽  
Vol 9 (suppl e) ◽  
pp. 30E-34E
Author(s):  
Alasdair P MacGowan ◽  
Tracey Halladay ◽  
Andrew M Lovering
Keyword(s):  
Respiratory Tract ◽  
Hospital Stay ◽  
Lower Respiratory Tract ◽  
Community Acquired Pneumonia ◽  
Economic Evaluations ◽  
Chronic Obstructive ◽  
National Guidelines ◽  
Obstructive Pulmonary Disease ◽  
Duration Of Hospital Stay ◽  
Tract Infections

A number of national guidelines have been published to aid the antimicrobial management of community-acquired pneumonia. However, data on prescriptions for lower respiratory tract infection (LRTI) indicate considerable variation in the choice of first-line and subsequent therapy at national and local levels. Outcomes research in LRTI, whether based on clinical, economic or patient-focused criteria, is still evolving. Clinical outcomes are best studied for both pneumonia and exacerbation of chronic obstructive pulmonary disease. Economic evaluations often do not encompass all of the costs, for example, time off from work or the economic impact of antibacterial resistance. Duration of hospital stay is a good marker of costs for hospital providers and may be affected by age. marital status and comorbidities. Antibiotic choice may have an impact on the duration of hospital stay by increasing side effects, predisposing patients to hospitalacquired infection or reduced clinical efficacy. Patient expectation is largely unstudied in pulmonary infection.

scholarly journals Comprehensive Description of Pathogens and Antibiotic Treatment Guidance in Children With Community-Acquired Pneumonia Using Combined Mass Spectrometry Methods

2021 ◽  
Vol 11 ◽  
Author(s):  
Liying Sun ◽  
Chi Zhang ◽  
Shuhua An ◽  
Xiangpeng Chen ◽  
Yamei Li ◽  
...  
Keyword(s):  
Mass Spectrometry ◽  
Antibiotic Therapy ◽  
Antibiotic Treatment ◽  
Community Acquired Pneumonia ◽  
Molecular Testing ◽  
Respiratory Pathogens ◽  
National Guidelines ◽  
Culture Methods ◽  
Identification Rate ◽  
Infection Pattern

The objective of this study was to evaluate the value of molecular methods in the management of community-acquired pneumonia (CAP) in children. Previously developed mass spectrometry (MS)-based methods combined with quantitative real-time PCR (combined-MS methods) were used to describe the aetiology and evaluate antibiotic therapy in the enrolled children. Sputum collected from 302 children hospitalized with CAP were analyzed using the combined-MS methods, which can detect 19 viruses and 12 bacteria related to CAP. Based on the results, appropriate antibiotics were determined using national guidelines and compared with the initial empirical therapies. Respiratory pathogens were identified in 84.4% of the patients (255/302). Co-infection was the predominant infection pattern (51.7%, 156/302) and was primarily a bacterial-viral mixed infection (36.8%, 111/302). Compared with that using culture-based methods, the identification rate for bacteria using the combined-MS methods (61.8%, 126/204) increased by 28.5% (p <0.001). Based on the results of the combined-MS methods, the initial antibiotic treatment of 235 patients was not optimal, which mostly required switching to β-lactam/β-lactamase inhibitor combinations or reducing unnecessary macrolide treatments. Moreover, using the combined-MS methods to guide antibiotic therapy showed potential to decrease the length of stay in children with severe CAP. For children with CAP, quantitative molecular testing on sputum can serve as an important complement to traditional culture methods. Early aetiology elucidated using molecular testing can help guide the antibiotic therapy.

The impact of national recommendations on antibiotic treatment of community acquired pneumonia. Do pediatricians follow the national guidelines?

2017 ◽  
Author(s):  
Grażyna Kraj ◽  
Katarzyna Krenke ◽  
Joanna Peradzyńska ◽  
Julita Chądzyńska ◽  
Krystian Wołoszyn ◽  
...  
Keyword(s):  
Antibiotic Treatment ◽  
Community Acquired Pneumonia ◽  
National Guidelines ◽  
The Impact
Sign in / Sign up

Export Citation Format

Share Document