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Sequential antimicrobial therapy: treatment of severe lower respiratory tract infections in children
F A Al-Eidan1, J C McElnay, M G Scott
1Pharmacy Practice Research Group, School of Pharmacy, The Queen's University of Belfast, Ireland.
Insights
Sequential antimicrobial therapy (SAT) in children with severe respiratory infections significantly reduces hospital stays and costs. This approach offers comparable clinical outcomes to traditional methods, making it a valuable cost-saving strategy.
Area of Science:
- Pediatric Infectious Diseases
- Antimicrobial Stewardship
- Health Economics
Background:
- Limited research exists on sequential antimicrobial therapy (SAT) in pediatric populations.
- Severe lower respiratory tract infections (LRTI) in children often require prolonged antimicrobial treatment.
- Current treatment protocols may lead to extended hospital stays and high healthcare costs.
Purpose of the Study:
- To evaluate the impact of a sequential antimicrobial therapy (SAT) protocol in pediatric patients.
- To assess the effectiveness of SAT in treating severe lower respiratory tract infections (LRTI) in children.
- To determine the economic implications of implementing SAT in pediatric care.
Main Methods:
- A study involving 89 pediatric patients diagnosed with severe lower respiratory tract infection.
- Patients were divided into two groups: a control group (44 patients) and a sequential antimicrobial therapy (SAT) group (45 patients).
- Comparison of length of hospital stay, duration of inpatient antimicrobial therapy (IV and oral), and total healthcare costs between the groups.
Main Results:
- SAT patients experienced a significantly shorter length of hospital stay (4.0 vs. 8.3 days).
- Duration of inpatient antimicrobial therapy was reduced in the SAT group (4.0 vs. 7.9 days), with IV therapy duration decreasing from 5.6 to 1.7 days.
- Total healthcare costs were reduced by 52% in the SAT group compared to the control group.
Conclusions:
- Sequential antimicrobial therapy (SAT) provides clinical outcomes comparable to longer-term IV therapy for severe pediatric lower respiratory tract infections.
- SAT significantly reduces hospital stay duration and antimicrobial treatment duration in pediatric patients.
- Implementing SAT is an effective cost-minimizing strategy, leading to substantial healthcare cost savings in pediatric care.
Abstract:
Although there have been a number of studies in adults, to date there has been little research into sequential antimicrobial therapy (SAT) in paediatric populations. The present study evaluates the impact of a SAT protocol for the treatment of severe lower respiratory tract infection in paediatric patients. The study involved 89 paediatric patients (44 control and 45 SAT). The SAT patients had a shorter length of hospital stay (4.0 versus 8.3 days), shorter duration of inpatient antimicrobial therapy (4.0 versus 7.9 days) with the period of iv therapy being reduced from a mean of 5.6 to 1.7 days. The total healthcare costs were reduced by 52%. The resolution of severe lower respiratory tract infection with a short course of iv antimicrobials, followed by conversion to oral therapy yielded clinical outcomes comparable to those achieved using longer term iv therapy. SAT proved to be an important cost-minimizing tool for realizing substantial healthcare costs savings.