Related Experiment Video

Updated: Jan 14, 2026

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Published on: August 30, 2018

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Intravenous line-related outcomes by antibiotic route for children hospitalized with pneumonia

Jillian M Cotter1, Angela Dunn2, Isabella Zaniletti3

  • 1Section of Hospital Medicine, Department of Pediatrics, Children's Hospital Colorado, University of Colorado, Aurora, Colorado, USA.

Journal of Hospital Medicine
|October 24, 2025
PubMed

Insights

Initial oral antibiotics for pediatric pneumonia reduce peripheral intravenous catheter (PIV) use and complications like infiltration/extravasation. This approach enhances patient experience and minimizes PIV-related harms.

Area of Science:

  • Pediatric hospital medicine
  • Infectious disease management
  • Patient safety

Background:

  • Peripheral intravenous catheters (PIVs) are common in hospitalized children.
  • PIV complications, such as infiltration and extravasation, can cause pain and morbidity.
  • Antibiotic administration route may influence PIV utilization and associated risks.

Purpose of the Study:

  • To compare PIV utilization and complication rates between children with pneumonia receiving initial oral versus intravenous antibiotics.
  • To assess the association between antibiotic route and PIV-related harms.

Main Methods:

  • Retrospective cohort study.
  • Involved 1035 children hospitalized with pneumonia across four sites (2014-2020).
  • Compared PIV outcomes using bivariable and multivariable regression analyses.

Main Results:

  • 65% of children received initial oral antibiotics; 59% had PIVs.
  • Children receiving IV antibiotics had significantly higher PIV placement rates (99%) compared to those on oral antibiotics (38%).
  • Infiltration/extravasation rates were lower in children on oral antibiotics (1%) versus IV antibiotics (9%), with lower odds for oral antibiotic group (OR: 0.39).

Conclusions:

  • Initial oral antibiotic therapy for pediatric pneumonia is associated with reduced PIV utilization.
  • Choosing oral antibiotics over IV antibiotics can significantly decrease the risk of PIV infiltration/extravasation.
  • Oral antibiotic initiation offers a strategy to improve pediatric patient experience and minimize PIV-related morbidity.

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