Antibiotic Use and Treatment Outcomes among Children with Community-Acquired Pneumonia Admitted to a Tertiary Care
Bhishma Pokhrel1, Tapendra Koirala2, Dipendra Gautam3
1Patan Hospital, Patan Academy of Health Sciences, Lalitpur 44700, Nepal.
Insights
Ampicillin remains effective for treating community-acquired pneumonia in hospitalized children, even with prior antibiotic exposure. Most children recovered fully, underscoring ampicillin
Area of Science:
- Pediatric Infectious Diseases
- Antimicrobial Stewardship
- Respiratory Medicine
Background:
- Growing antimicrobial resistance raises concerns about first-line antibiotic efficacy.
- Community-acquired pneumonia (CAP) is a common childhood illness requiring hospitalization.
- Assessing antibiotic use patterns and outcomes in CAP is crucial for effective treatment strategies.
Purpose of the Study:
- To describe antibiotic utilization and treatment outcomes in hospitalized children under five with CAP in Nepal.
- To evaluate the effectiveness of ampicillin monotherapy as a first-line treatment for pediatric CAP.
- To analyze the impact of prehospital antibiotic use on treatment choices and outcomes.
Main Methods:
- Cross-sectional study utilizing secondary analysis of hospital data.
- Inclusion of 659 children under five admitted with CAP between 2017 and 2019.
- Retrospective review of antibiotic prescriptions, treatment lines, and patient outcomes.
Main Results:
- Ampicillin monotherapy was the most frequent first-line treatment (70%), irrespective of prehospital antibiotic use.
- Ceftriaxone was used as first-line therapy in 12% of cases.
- A high recovery rate (99%) was observed with minimal need for second- (10%) or third-line (1%) treatments.
Conclusions:
- Ampicillin monotherapy demonstrates effectiveness in treating hospitalized children with CAP in a non-intensive care setting.
- Current antibiotic strategies, including ampicillin, appear successful in managing pediatric CAP in this region.
- The study supports the continued use of ampicillin as a primary treatment option for pediatric CAP.
Abstract:
In the era of growing antimicrobial resistance, there is a concern about the effectiveness of first-line antibiotics such as ampicillin in children hospitalized with community-acquired pneumonia. In this study, we describe antibiotic use and treatment outcomes among under-five children with community-acquired pneumonia admitted to a tertiary care public hospital in Nepal from 2017 to 2019. In this cross-sectional study involving secondary analysis of hospital data, there were 659 patients and 30% of them had a history of prehospital antibiotic use. Irrespective of prehospital antibiotic use, ampicillin monotherapy (70%) was the most common first-line treatment provided during hospitalization followed by ceftriaxone monotherapy (12%). The remaining children (18%) were treated with various other antibiotics alone or in combination as first-line treatment. Broad-spectrum antibiotics such as linezolid, vancomycin, and meropenem were used in less than 1% of patients. Overall, 66 (10%) children were required to switch to second-line treatment and only 7 (1%) children were required to switch to third-line treatment. Almost all (99%) children recovered without any sequelae. This study highlights the effectiveness of ampicillin monotherapy in the treatment of community-acquired pneumonia in hospitalized children in a non-intensive care unit setting.
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