CAP outcomes equal with broad-, narrow-spectrum therapy
Different clinical outcomes and costs are not seen in children hospitalized with community-acquired pneumonia whether they are treated with narrow- or broad-spectrum antimicrobial therapy, according to recent study findings published in Pediatrics.
The study included 15,564 children aged 6 months to 18 years hospitalized with community-acquired pneumonia (CAP) between July 1, 2005, and June 30, 2011, who received either parenteral ampicillin/penicillin (narrow spectrum) or ceftriaxone/cefotaxime (broad spectrum) treatment.
Overall, 89.7% of participants received broad-spectrum therapy and 10.3% received narrow-spectrum. Median length of stay was 3 days for both groups (adjusted difference, 0.12 days; 95% CI, –0.02 to 0.26).
One percent of patients receiving broad-spectrum therapy and 0.8% receiving narrow-spectrum therapy were admitted to the ICU (adjusted OR=0.85; 95% CI, 0.27-2.73). Readmission occurred in 2.3% of patients receiving broad-spectrum and 2.4% of patients receiving narrow-spectrum therapy. Hospitalization median costs were $3,992 for broad-spectrum therapy and $4,375 for narrow-spectrum therapy.
“Clinical outcomes and costs for children hospitalized with CAP are not different when empirical treatment is with narrow-spectrum compared with broad-spectrum therapy,” the researchers wrote. “Few institutions used narrow-spectrum therapy routinely before publication of the PIDS/IDSA CAP management guidelines. Programs promoting guideline implementation and targeting judicious antibiotic selections for CAP are needed to optimize management of childhood CAP in the United States.”
Disclosure: The researchers report no relevant financial disclosures.