Document Type
Article
Publication Date
12-1-2016
Identifier
DOI: 10.1542/peds.2016-1692
Abstract
BACKGROUND AND OBJECTIVES: Postdischarge treatment of complicated pneumonia includes antibiotics administered intravenously via a peripherally inserted central venous catheter (PICC) or orally. Antibiotics administered via PICC, although effective, may result in serious complications. We compared the effectiveness and treatment-related complications of postdischarge antibiotics delivered by these 2 routes.
METHODS: This multicenter retrospective cohort study included children ≥2 months andadministration, classified as PICC or oral. The primary outcome was treatment failure. Secondary outcomes included PICC complications, adverse drug reactions, other related revisits, and a composite of all 4 outcomes, termed "all related revisits."
RESULTS: Among 2123 children, 281 (13.2%) received antibiotics via PICC. Treatment failure rates were 3.2% among PICC and 2.6% among oral antibiotic recipients and were not significantly different between the groups in across-hospital-matched analysis (matched odds ratio [OR], 1.26; 95% confidence interval [CI], 0.54 to 2.94). PICC complications occurred in 7.1%. Adverse drug reactions occurred in 0.6% of children; PICC antibiotic recipients had greater odds of adverse drug reaction in across hospital matched analysis (matched OR, 19.1; 95% CI, 4.2 to 87.3). The high rate of PICC complications and differences in adverse drug reactions contributed to higher odds of the composite outcome of all related revisits among PICC antibiotic recipients (matched OR, 4.71; 95% CI, 2.97 to 7.46).
CONCLUSIONS: Treatment failure rates between PICC and oral antibiotics did not differ. Children with complicated pneumonia should preferentially receive oral antibiotics at discharge when effective oral options are available.
Journal Title
Pediatrics
Volume
138
Issue
6
MeSH Keywords
Administration, Intravenous; Administration, Oral; Adolescent; Anti-Bacterial Agents; Catheterization, Peripheral; Child; Child, Preschool; Cohort Studies; Humans; Infant; Patient Discharge; Pneumonia; Retrospective Studies; Treatment Failure
Recommended Citation
Shah SS, Srivastava R, Wu S, et al. Intravenous Versus Oral Antibiotics for Postdischarge Treatment of Complicated Pneumonia. Pediatrics. 2016;138(6):e20161692. doi:10.1542/peds.2016-1692
Included in
Bacterial Infections and Mycoses Commons, Infectious Disease Commons, Pediatrics Commons, Pharmaceutical Preparations Commons, Respiratory Tract Diseases Commons
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