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A Robust Pneumonia Model in Immunocompetent Rodents to Evaluate Antibacterial Efficacy against S. pneumoniae, H. influenzae, K. pneumoniae, P. aeruginosa or A. baumannii
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Narrow vs broad-spectrum antimicrobial therapy for children hospitalized with pneumonia

Derek J Williams1, Matthew Hall, Samir S Shah

  • 11161 21st Ave South, CCC 5311 Medical Center North, Nashville, TN 37232. derek.williams@vanderbilt.edu.

Pediatrics
|October 30, 2013
PubMed

Insights

Narrow-spectrum antibiotics are as effective as broad-spectrum antibiotics for pediatric community-acquired pneumonia (CAP). This study found no significant differences in clinical outcomes or costs for children treated with either therapy.

Area of Science:

  • Pediatric Infectious Diseases
  • Antimicrobial Stewardship
  • Health Services Research

Background:

  • Current guidelines recommend narrow-spectrum antibiotics for pediatric community-acquired pneumonia (CAP).
  • Evidence on the effectiveness of this narrow-spectrum approach is limited.
  • This study evaluates the impact of narrow-spectrum versus broad-spectrum antibiotic therapy in hospitalized children with CAP.

Purpose of the Study:

  • To compare clinical outcomes and resource utilization in children hospitalized with CAP.
  • To assess the effectiveness of narrow-spectrum (ampicillin/penicillin) versus broad-spectrum (ceftriaxone/cefotaxime) parenteral antibiotic therapy.

Main Methods:

  • Retrospective cohort study utilizing data from 43 children's hospitals (2005-2011).
  • Compared outcomes and resource utilization between narrow- and broad-spectrum antibiotic groups.
  • Excluded children with complex conditions, transfers, recent hospitalizations, or severe early complications (ICU admission, ventilation, death).

Main Results:

  • 1610 children received narrow-spectrum therapy (10.3%) and 13,954 received broad-spectrum therapy (89.7%).
  • No significant differences in median length of stay (3 days), intensive care unit admissions (1.1% vs 0.8%), or readmissions (2.3% vs 2.4%).
  • Median hospitalization costs were similar ($3992 vs $4375), with no statistically significant adjusted difference.

Conclusions:

  • Narrow-spectrum antibiotic therapy is clinically equivalent to broad-spectrum therapy for hospitalized pediatric CAP.
  • No significant differences in key outcomes or healthcare costs were observed between the two treatment strategies.
  • Findings support the guideline recommendation for narrow-spectrum antibiotic use in pediatric CAP.
Abstract

Keywords:
antibiotic useeffectivenesspediatricspneumonia

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