Nav: Home

Good news for kids recovering from complex pneumonia

November 17, 2016

CINCINNATI - In some good news for families of children recovering from complex pneumonia, doctors recommend in a study published by Pediatrics it's better to send kids home from the hospital with oral instead of intravenous antibiotics.

Children with complex pneumonia typically require one to three weeks of antibiotic therapy after hospital discharge to treat residual infection. The relief of going home without a needle and tube stuck to a child's arm also comes with other benefits, according to a multi-institutional research team led by Cincinnati Children's Hospital Medical Center.

Appearing in the journal's Nov. 17 eFirst edition, the retrospective study of 2,123 children at 36 hospitals found oral antibiotics are as effective as intravenous in managing residual disease. Taking medication by mouth also avoids the risk of infection and other medical complications from peripherally inserted central venous catheters, or PICC lines.

"PICC line complications can be serious, resulting in hospital readmission, additional procedures, and more medications, as well as missed work or school." says Samir Shah, MD, MSCE, the study's lead author and director of Hospital Medicine at Cincinnati Children's Hospital Medical Center. "It's not surprising that children and families would rather not use PICC lines. Our findings, which provide compelling evidence to support the use of oral antibiotics for children with complex pneumonia, will contribute to safer care for children across the country."

The paper is the first multi-center research project to look at the issue. The study is a collaboration of the Pediatric Research in Inpatient Settings Network -- a group of pediatric hospitalists focused on improving care delivery to children.

About 15 percent of children hospitalized for pneumonia develop complicated pneumonia, which includes the buildup of fluid around the lungs caused by pleural infection, according to the authors.

National treatment guidelines do not call for the use oral antibiotics after leaving the hospital, although they do highlight the risk of giving the medicine intravenously. The researchers report that although PICC use is overall not common, they found substantial variation in post-discharge use across the 36 hospitals in the study with almost three-fourths of children at some hospitals receiving antibiotics by PICC for complex pneumonia. An important goal of the research is helping reduce what the authors call "unwarranted variation" or differences in care that are not related to the child's illness or underlying medical conditions.

Of the 2,123 children in the study, 281 (13.2 percent) received antibiotics through a PICC line after release from the hospital, with the rest getting oral antibiotics. Treatment failure rates were not significantly different between the groups -- with 3.2 percent failure rate for kids on a PICC line and 2.6 percent for the oral antibiotics group. PICC-related complications occurred in 7.1 percent of children in that group; adverse drug reactions were recorded for 0.6 percent of children taking oral medication.

This led the authors to conclude that children with complicated pneumonia should "preferentially receive" oral antibiotics when released from the hospital when effective oral options are available.
-end-
Funding support for the study came from the Patient-Centered Outcomes Research Institute (grant # 4252940000).

Cincinnati Children's Hospital Medical Center

Related Pneumonia Articles:

Antibiotic therapy for nearly 1 in 4 adults with pneumonia does not work
Approximately one in four (22.1 percent) adults prescribed an antibiotic in an outpatient setting (such as a doctor's office) for community-acquired pneumonia does not respond to treatment, according to a new study presented at the 2017 American Thoracic Society International Conference.
Discovery may help patients beat deadly pneumonia
Researchers have identified a hormone that helps fight off a severe form of bacterial pneumonia, and that discovery may offer a simple way to help vulnerable patients.
Community-acquired pneumonia can spread year-round
New research indicates that community-acquired pneumonia should not be regarded as a seasonal disease, as it occurs throughout all seasons; however, the pathogens that cause the condition are clearly subject to seasonal variations.
Among antidementia drugs, memantine is associated with the highest risk of pneumonia
A recent study from the University of Eastern Finland shows that among users of antidementia drugs, persons using memantine have the highest risk of pneumonia.
Good news for kids recovering from complex pneumonia
In some good news for families of children recovering from complex pneumonia, doctors recommend in a study published by Pediatrics it's better to send kids home from the hospital with oral instead of intravenous antibiotics.
Ventilator-associated pneumonia rates remain stable, substantial
In a study published online by JAMA, Mark L. Metersky, M.D., of the UConn School of Medicine, Farmington, and colleagues analyzed trends in Medicare Patient Safety Monitoring System ventilator-associated pneumonia rates from 2005 through 2013.
Pneumonia rates linked to hospital ventilators have not dropped
Contrary to data published by the Centers for Disease Control, ventilator-associated pneumonia rates in hospital intensive care units have not declined significantly since 2005, according to a new study out of the University of Connecticut School of Medicine.
Vitamin E may prevent pneumonia in nonsmoking elderly men
Administration of 50 mg per day of vitamin E decreased the risk of pneumonia in elderly male smokers by 72 percent after they quit smoking, according to a paper published in Clinical Interventions in Aging.
New model sheds light on secondary bacterial pneumonia
For years, researchers have known that the bacteria Staphylococcus aureus can trigger severe, sometimes deadly secondary bacterial pneumonia, in some people who are subsequently infected with influenza A virus, but scientists have not known exactly how this happens.
Pneumonia discovery may offer way to boost body's defenses
The finding may offer a new way for doctors to boost patients' ability to fight off the life-threatening infection as bacteria become more and more resistant to antibiotics.

Related Pneumonia Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Digital Manipulation
Technology has reshaped our lives in amazing ways. But at what cost? This hour, TED speakers reveal how what we see, read, believe — even how we vote — can be manipulated by the technology we use. Guests include journalist Carole Cadwalladr, consumer advocate Finn Myrstad, writer and marketing professor Scott Galloway, behavioral designer Nir Eyal, and computer graphics researcher Doug Roble.
Now Playing: Science for the People

#530 Why Aren't We Dead Yet?
We only notice our immune systems when they aren't working properly, or when they're under attack. How does our immune system understand what bits of us are us, and what bits are invading germs and viruses? How different are human immune systems from the immune systems of other creatures? And is the immune system so often the target of sketchy medical advice? Those questions and more, this week in our conversation with author Idan Ben-Barak about his book "Why Aren't We Dead Yet?: The Survivor’s Guide to the Immune System".