Community Acquired Pneumonia in Children, Antibiotic Stewardship
Conditions
Keywords
Community acquired pneumonia, Antibiotic use, Pediatrics, Hospitalised children, Integrative medicine
Brief summary
A study to observe how often antibiotics are prescribed in children hospitalized for pneumonia and how doctors decide if a child needs antibiotics or not. Parent satisfaction will also be recorded.
Detailed description
An observational study to document the antibiotic treatment rate of children hospitalized for community acquired pneumonia at a pediatric department with longstanding practice of restrictive antibiotic prescribing. Patients will be enrolled consecutively and treated according to in-house standard operating procedure. Antibiotic treatment rate, severity of disease and medical complication rate in antibiotic and non-antibiotic managed children, frequency of predefined factors in physician decision making on antibiotic use, and parental satisfaction will be recorded. Parents will be contacted at least 4 weeks after discharge to inquire about recurrence or readmission.
Interventions
OTHERAntibiotic treatment
Antibiotic treatment
No antibiotic treatment
Sponsors
Gemeinschaftskrankenhaus Herdecke, Germany
ARCIM Institute Academic Research in Complementary and Integrative Medicine
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
3 Months to 18 Years
Healthy volunteers
No
Inclusion criteria
* Hospital admission at the pediatric department of the Filderklinik or at the pediatric department of the Herdecke Community Hospital * Admission diagnosis pneumonia or pneumonia diagnosis within 48 hours of admission * Written informed consent by care giver * All inclusion criteria have to be fulfilled
Exclusion criteria
* Insufficient knowledge of German to understand the written patient information and questionnaire
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Antibiotic treatment rates in hospitalized children with non-severe community-acquired pneumonia and fever | During hospitalization, an average of 7 days | Rates of treatment with and without antibiotics during hospitalization |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Factors in physician decision making on antibiotic prescription | During hospitalization, an average of 7 days | Physician questionnaire (closed-ended questions) |
| Parental satisfaction | At discharge, assessing the entire duration of the hospital stay, an average of 7 days | Parental satisfaction questionnaire (closed-ended questions) |
| Hospitalization duration | At discharge, assessing the entire duration of the hospital stay, an average of 7 days | Number of hospitalization days |
| Number of children with relevant comorbidity | During hospitalization, an average of 7 days | Co-morbidities that may affect decision on antimicrobial use: a) chronic conditions (e.g. neurological conditions such as cerebral palsy, Down syndrome; or chronic respiratory conditions such as asthma, cystic fibrosis; or heart conditions). b) acute infectious comorbidities: bronchiolitis, otitis media, urinary tract infection, confirmed influenza virus or Respiratory Syncytial Virus or SARS-CoV2. |
| Number of medical complications | During hospitalization, an average of 7 days | Medical complications defined as a) admission to intensive care, mechanical ventilation, transfer to tertiary car center OR b) pleural effusion or empyema, pneumothorax, lung abscess, bronchopleural fistula, necrotizing pneumonia, acute respiratory failure, infectious complication (meningitis, septic shock). |
| Use of antipyretic medications | During hospitalization, an average of 7 days | Number of doses of paracetamol or ibuprofen during hospitalization |
| Number of complementary medicine medications used per child | During hospitalization, an average of 7 days | Number of complementary medication during hospitalization |
| Number of readmissions for pneumonia or new pneumonia recurrences within 4 weeks of hospital discharge | 4 weeks after end of hospitalization | New hospital admission for pneumonia; treatment requiring recurrence of pneumonia |
| Days of supplemental oxygen use | During hospitalization, an average of 7 days | Oxygen therapy for O2 saturation \<92% |
Countries
Germany
Contacts
Primary ContactJan Vagedes, Dr
Outcome results
None listed