Comparison of Short- vs Long-Course Antibiotic Therapy for Children With Tracheitis Associated With an Artificial

Tracy N Zembles1, Rainer G Gedeit2, Martin K Wakeham2

  • 1Department of Enterprise Safety; Children's Wisconsin, Milwaukee, WI, USA.

Pediatric Pulmonology
|January 21, 2026
PubMed

Insights

Shorter antibiotic courses for tracheitis (5 days) are as effective as longer courses (7+ days). Limiting antibiotic duration does not worsen patient outcomes, supporting shorter treatment durations.

Area of Science:

  • Pediatric critical care medicine
  • Infectious diseases
  • Antimicrobial stewardship

Background:

  • Tracheitis treatment duration is a key area for antimicrobial stewardship.
  • Optimizing antibiotic use is crucial to combat resistance and improve patient outcomes.

Purpose of the Study:

  • To compare outcomes of short-course versus long-course antibiotic therapy for pediatric tracheitis.
  • To evaluate the impact of antibiotic duration on re-treatment, new infections, and mortality.

Main Methods:

  • Retrospective cohort study of pediatric intensive care unit patients with tracheitis requiring antibiotics.
  • Comparison of outcomes between patients receiving ≤6 days (short course) versus ≥7 days (long course) of antibiotics.
  • Analysis of re-treatment rates, new pneumonia, and multi-drug resistant organism development.

Main Results:

  • 95 patients analyzed: 42 (short course, median 5 days) and 53 (long course, median 9 days).
  • No statistically significant difference in composite outcomes (re-treatment/pneumonia) or 30-day mortality between groups.
  • Antibiotic duration did not impact the development of subsequent multi-drug resistant organisms.

Conclusions:

  • Short-course antibiotic therapy (≤6 days) for tracheitis is not associated with worse outcomes compared to longer courses.
  • A 5-day antibiotic duration for pediatric tracheitis is recommended, aligning with antimicrobial stewardship principles.
Abstract

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