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Antibiotic Therapy and Factors Predicting Prolonged Hospitalization Among Children Under Three Years Diagnosed With
1Department of Child Health, College of Medicine, King Khalid University, Abha, Saudi Arabia.
Insights
Antibiotic overuse is common in children hospitalized with respiratory syncytial virus (RSV) lower respiratory infections (LRIs). Antibiotic use and factors like pneumonia and younger age predict longer hospital stays for RSV-LRIs.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Respiratory syncytial virus (RSV) is a leading cause of lower respiratory infections (LRIs) in infants and young children.
- Antibiotic overuse is a significant concern in managing RSV-associated LRIs in hospitalized pediatric patients.
- Differentiating RSV-LRIs from bacterial pneumonia presents clinical challenges.
Purpose of the Study:
- To determine the prevalence of antibiotic use in children hospitalized with RSV-associated LRIs.
- To identify predictors of prolonged hospitalization in this patient population.
Main Methods:
- Retrospective record review of 162 children (1-36 months) admitted with RSV-LRIs.
- Data collected included demographics, clinical findings, laboratory results, imaging, antibiotic therapy, and length of stay (LOS).
- Statistical analysis was performed to identify factors associated with prolonged LOS.
Main Results:
- A high proportion (90.74%) of patients received antibiotic therapy, commonly azithromycin, cefuroxime, and ceftriaxone.
- Antibiotic use was significantly associated with a longer median LOS (6 days vs. 3 days, p < 0.001).
- Independent predictors of prolonged LOS (≥5 days) included antibiotic therapy, pneumonia, younger age (<12 months), consolidation, higher respiratory rate, and lower SpO₂.
Conclusions:
- The high rate of antibiotic use underscores the difficulty in distinguishing RSV-LRIs from bacterial pneumonia.
- Antibiotic therapy, pneumonia, younger age, lower SpO₂, and increased respiratory rate are key predictors of prolonged hospitalization in children with RSV-LRIs.
Background:
Respiratory syncytial virus (RSV) is a common cause of lower respiratory infections (LRIs) in infants and young children. Antibiotic overuse remains a significant concern in hospitalized children with RSV-associated LRIs. This study aimed to investigate the prevalence of antibiotic use and identify predictors of prolonged hospitalization in children with RSV-LRIs.
Methods:
A retrospective record review study was conducted at Abha Maternity and Children's Hospital, enrolling 162 children aged 1-36 months admitted with RSV-associated LRIs between January and December 2022. Demographic, clinical, laboratory, and imaging data were collected. Antibiotic therapy and hospital length of stay (LOS) were also retrieved and analyzed.
Results:
Of the 162 patients, 147 (90.74%) received antibiotic therapy, with azithromycin, cefuroxime, and ceftriaxone being the most commonly used. Patients who received antibiotics had a significantly longer median LOS compared to those who did not (6 vs. 3 days, p < 0.001). Factors associated with prolonged LOS (≥ 5 days) included antibiotic therapy use (odds ratio [OR] = 7.47 (95% confidence intervals [CI]: 2.18-25.57), pneumonia: OR = 3.58 (95% CI: 1.67-7.67), age < 12 months: OR = 2.80 (95% CI: 1.32-5.89), consolidation: OR = 2.54 (95% CI: 1.16-5.59), age in months: OR = 0.94 (95% CI: 0.91-0.98) (indicates decreasing odds with increasing age), admission respiratory rate: OR = 1.04 (95% CI: 1.01-1.07), and admission peripheral oxygen saturation (SpO2): OR = 0.91 (95% CI: 0.86-0.97) (indicates decreasing odds with higher SpO2).
Conclusion:
The high prevalence of antibiotic use in this study highlights the challenges in differentiating RSV-LRIs from bacterial pneumonia. Independent predictors of prolonged hospital stay included antibiotic therapy, pneumonia, younger age, lower admission SpO₂, and higher respiratory rate.
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