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Appropriateness of testing for serious bacterial infection in children hospitalized with bronchiolitis

Jamie Librizzi1, Russell McCulloh, Kristin Koehn

  • 1Department of Pediatrics, Children's National Medical Center, George Washington School of Medicine and Health Science, Washington, DC;

Hospital Pediatrics
|January 18, 2014
PubMed

Insights

Serious bacterial infections (SBI) are uncommon in children hospitalized with bronchiolitis. SBI testing in these patients is linked to longer hospital stays and increased antibiotic use, with urinary tract infections being the most common diagnosis.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Hospital Medicine

Background:

  • Bronchiolitis is a common pediatric respiratory illness.
  • Evaluation for serious bacterial infections (SBI) is a concern in hospitalized infants.
  • Practice patterns for SBI testing in bronchiolitis vary.

Purpose of the Study:

  • To evaluate provider practices for SBI testing in hospitalized bronchiolitis patients.
  • To assess the association between SBI testing and length of stay (LOS).
  • To determine the relationship between SBI testing and antibiotic use.

Main Methods:

  • Retrospective chart review of 1233 patients <24 months old diagnosed with bronchiolitis.
  • Data collected from 2004-2008 across two study sites.
  • Analysis of patient characteristics, laboratory testing, antibiotic use, and clinical outcomes relative to SBI testing.

Main Results:

  • Urinary tract infection was the most common SBI (2.3% incidence).
  • No meningitis cases were reported; blood cultures often showed contamination.
  • SBI testing was associated with increased antibiotic use (53.8% vs 19.1%) and longer LOS (3.4 vs 2.3 days).

Conclusions:

  • SBI is infrequent in children hospitalized for bronchiolitis.
  • Urinary tract infection is the most common SBI identified.
  • SBI evaluation in bronchiolitis is linked to higher antibiotic consumption and extended hospital stays.
Abstract

Keywords:
bacteremiabacterial infectionsbronchiolitismeningitisurinary tract infection

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