Researchers to study delayed antibiotic strategy for kids with mild pneumonia

News brief

Mom and sick child — dragana991 / iStock

Ann & Robert H. Lurie Children's Hospital of Chicago announced last week that it has been awarded $12 million to study a new strategy for prescribing antibiotics in young children with mild pneumonia.

In partnership with University of Utah Health, clinicians and researchers at Lurie Children's will investigate whether an approach known as safety-net antibiotic prescription (SNAP) results in reduced antibiotic use and similar clinical improvement compared with immediate antibiotic use, which is the current standard of care for young children with mild pneumonia. With the SNAP approach, providers don't give the child an antibiotic unless the child's symptoms worsen or do not improve within 3 days.

The study will be conducted at Lurie Children's and three other pediatric emergency departments across the country, as well as 12 pediatric primary care offices and three urgent care centers that are part of the Pediatric Research Consortium at Children's Hospital of Philadelphia. The funding comes from the Patient-Centered Outcomes Research Institute.

Avoiding unnecessary antibiotics

Co-principal study investigator Todd Florin, MD, of Lurie Children's and Northwestern University Feinberg School of Medicine, said the SNAP strategy is currently recommended for children's ear infections but has not been evaluated in pneumonia.

"Most pneumonias in young children are caused by a virus, which the body fights off without antibiotics," Florin said in a hospital press release. "Despite this, most children with pneumonia are currently treated with antibiotics. It is important to avoid exposing children to unnecessary antibiotics for many reasons, including their side effects, such as rashes that can mimic allergies or an upset stomach."

Julia Szymczak, PhD, of University of Utah Health, said the study could generate evidence that will help parents and pediatricians navigate what can be a difficult decision.

"Nobody wants to give unnecessary medicine, but it is scary to care for a child with pneumonia and it’s often unclear whether an antibiotic will help," she said. "SNAP empowers parents to give their child a chance to fight off the infection on their own while also having fast access to antibiotics if it becomes clear they are needed."

CDC alerts providers about spike in parvovirus B19 activity

News brief

Lisa Schnirring

The Centers for Disease Control and Prevention (CDC) yesterday sent an alert to health providers about a rise in parovirus B19 infections in the United States.

child with face rash — Timothy Takemoto/Flickr cc

Though the disease isn't typically included in US surveillance, the CDC said it had received multiple reports of increased activity, including data from commercial labs, serology in the general population, and serology among blood donors. In its Health Alert Network notice, the CDC also said it has receive reports of clusters of parvovirus B19 complications in pregnant women, and people who have sickle cell disease.

The group added the European region experienced a rise in cases in the first quarter of 2024.

Highly transmissible and a threat to at-risk groups

Parvovirus B19 is highly transmissible by respiratory droplets and is known to spread in households as well as trigger school outbreaks. The virus can also spread from pregnant women to their fetuses and can be transmitted through transfusion of blood components and certain plasma derivatives. Also called "fifth disease", hallmarks of the illness include a "slapped cheek" rash in children and joint pain in adults.

Most people recover with supportive care, but parvovirus B19 infections can lead to serious complications in certain groups, as well as adverse fetal outcomes.

The CDC urged health providers to keep a high index of suspicion in people who present with compatible physical symptoms and lab markers, especially those at higher risk including pregnant women, immunocompromised people, and those with chronic hemolytic blood disorders.