Antibiotic Treatment of Children Hospitalized with Pneumonia

In 2011, the Pediatric Infectious Diseases Society guidelines for management of community-acquired pneumonia (CAP) in infants (age >3 months) and children recommended use of narrow-spectrum antibiotics for outpatient (e.g., amoxicillin) and inpatient (e.g., ampicillin) management of uncomplicated CAP. Researchers retrospectively studied outcomes associated with this strategy using data from 43 free-standing children's hospitals in the Pediatric Health Information System database.

Between 2005 and 2011, nearly 150,000 children (age range, 6 months – 18 years) were hospitalized with CAP; of these, 15,564 children were included in the study after excluding children with complicated pneumonia, possible healthcare-associated pneumonia, and complex chronic conditions. Ninety percent of study children received broad-spectrum antibiotics and 10% received narrow-spectrum antibiotics. No significant differences were found between the two groups in median length of stay (3 days), transfer to the intensive care unit after 2 days of hospitalization (1.1% and 0.8%), readmissions within 14 days (2.3% and 2.4%), and median cost of hospitalization. Matched analysis of propensity scores in 1044 children in each exposure group also showed no difference between groups. Subgroup analysis of 4876 children with acute wheezing and pneumonia found no differences in outcomes between antibiotic groups or between wheezing and nonwheezing groups.