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Prediction of delayed recovery from pediatric community-acquired pneumonia
Massimiliano Don1, Francesca Valent, Mario Canciani
1Pediatric Care Unit, Sant'Antonio General Hospital, San Daniele del Friuli, Udine, Italy. max.don@libero.it
Insights
Children with community-acquired pneumonia (CAP) may face complications if they don't improve within 48 hours. This study examined factors influencing pediatric CAP recovery, finding age and antibiotic choice impacted fever duration. Certain clinical markers, however, did not predict treatment outcomes.
Area of Science:
- Pediatric Infectious Diseases
- Respiratory Medicine
Background:
- Community-acquired pneumonia (CAP) in children can lead to complications if antibiotic therapy is not effective within 48 hours.
- Prompt assessment is crucial for children with CAP not responding to initial treatment.
Purpose of the Study:
- To evaluate the improvement of pediatric CAP within 48 hours of antibiotic therapy.
- To analyze the influence of age, etiology, clinical/laboratory characteristics, and antibiotic selection on treatment outcomes.
Main Methods:
- Retrospective analysis of 94 children with radiologically confirmed CAP.
- Treatment administered included oral amoxicillin, intravenous ampicillin, or other antibiotics.
- Etiology was assessed via serology; over 20 clinical characteristics were collected.
Main Results:
- Older children (≥5 years) had a longer mean fever duration compared to younger age groups (p = 0.003).
- Fever persisted beyond 48 hours in 4.3% of children; 2 developed empyema.
- Amoxicillin and outpatient treatment were associated with longer fever duration compared to ampicillin and inpatient treatment, respectively.
Conclusions:
- Respiratory rate and erythrocyte sedimentation rate correlated with faster fever reduction.
- No specific clinical, laboratory, or etiological characteristic reliably predicted treatment failure or delayed fever decrease in pediatric CAP.
Background:
If children with community-acquired pneumonia (CAP) do not recover within 48 hours after starting antibiotic therapy, complications are possible and a checkup must be ensured.Aim of the present study was to evaluate the improvement of pediatric CAP, within 48 hours after starting therapy, in relation to age, etiology, clinical/laboratory characteristics and selected antibiotics.
Methods:
Ninety-four children were treated for radiologically confirmed CAP, 64 by oral amoxicillin, 23 by intravenous ampicillin and 7 by other antibiotics. The etiology of CAP was studied by serology, data on more than 20 clinical characteristics were collected retrospectively, and antibiotics were selected on clinical grounds.
Results:
After starting of antibiotics, the mean duration of fever was higher in children >or=5 than <2 or 2-4 years of age (p = 0.003). Fever continued >48 hours in 4 (4.3%) children and 2 additional children had empyema. Clinical, radiological and laboratory characteristics and serological findings were not significantly associated with the duration of fever. Fever continued >24 hours in 1 (4.8%) child treated with ampicillin and in 2 (8%) inpatients compared with 19 (28.8%) children treated with amoxicillin (p = 0.007) and 23 (33%) outpatients (p = 0.0012), respectively.
Conclusions:
Respiratory rate and erythrocyte sedimentation rates were associated with rapid decrease of fever. Anyway, none of the reported characteristics was able to predict treatment failures or delayed fever decrease in children suffering from CAP.
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