Young children with uncomplicated pneumonia could be OK without antibiotics

A study in Open Forum Infectious Diseases revealed that among children aged 3 years or younger who were hospitalized for uncomplicated community-associated pneumonia (CAP), a sizable proportion of them fared well without undergoing a full course of antibiotics.

In the retrospective, observational study, researchers from the University of Alabama at Birmingham examined data on previously healthy children aged 3 to 36 months who were treated at Children’s of Alabama for uncomplicated CAP from September 2011 through December 2019.

They compared outcomes in children treated with antibiotics—defined as treated for more than two days with an antibiotic or discharged home with an antibiotic prescription—with those of children who received two days of antibiotics or less or were discharged home with no antibiotics.

Tracked outcomes included illness severity, length of hospital stay, and readmission after discharge. A total of 322 children were included in the study, and 266 (83%) received more than two days of antibiotics or were discharged with antibiotics, while 56 children received two days or less of antibiotics and none at discharge with antibiotics. Further, 56 children received two days or less of antibiotics and none at discharge and 32 children received no antibiotics.

The proportion of patients treated with antibiotics decreased from 88% in the early part of the study period (2011–2013) to 66% from 2017 to 2019.

The researchers concluded, “It appears that a substantial proportion of previously healthy children less than 3 years of age hospitalized with uncomplicated CAP will do well without antibiotic treatment… Better tools for identifying those that require antibiotics will make it possible to achieve a significant advance in antibiotic stewardship.”