最初的抗生素路线与住院患有肺炎的儿童的结果之间的关联
Jillian M Cotter1, Isabella Zaniletti2, Derek J Williams3
1Department of Pediatrics, Section of Hospital Medicine, Children's Hospital Colorado, University of Colorado, Aurora, Colorado, USA.
将社区获得性肺炎 (CAP) 的住院儿童开始服用口服抗生素可以显著减少住院时间和医院费用. 这种方法是静脉注射 (IV) 抗生素的安全有效替代方案.
科学领域:
- 儿童传染病 儿童传染病
- 药物治疗 药物治疗
- 医疗服务研究 医疗服务研究
背景情况:
- 社区获得性肺炎 (CAP) 是一种常见的儿童疾病,需要住院治疗.
- 静脉注射 (IV) 抗生素是一种标准治疗方法,但口服抗生素可能具有类似的疗效.
- 需要进一步的研究来比较儿科CAP的初始抗生素路径.
研究的目的:
- 评估初始抗生素途径 (口服与静脉注射) 与CAP住院儿童的临床结果之间的关联.
- 为了比较住院时间 (LOS),医院费用,以及基于初始抗生素给药路线的二次结果.
主要方法:
- 2014年至2020年期间,多中心,回顾性队列研究涉及2014年至2020年期间住院治疗CAP的儿童.
- 包括住院时间超过48小时的儿童,胸部放射和抗生素治疗.
- 使用倾向性得分权重来比较初始口服和静脉抗生素组之间的结果.
主要成果:
- 在1147名儿童中,有37%的儿童接受了最初的口服抗生素.
- 最初的口服抗生素与LOS降低8% (OR 0.92) 和成本降低14% (OR 0.86) 相关.
- 没有观察到氧气持续时间,护理升级或再入院率的显著差异.
结论:
- 对于儿科CAP的初始口服抗生素治疗与更短的住院时间和更低的成本有关.
- 口服抗生素代表了一种安全有效的替代IV治疗治疗住院儿童的CAP.
- 这一发现支持临床实践的潜在转变,优先考虑口服抗生素.
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