Study: Young kids with simple pneumonia fare well without antibiotics
A study of children 3 years old or younger who were hospitalized for uncomplicated community-associated pneumonia (CAP) found that a significant proportion did well without a full course of antibiotics, researchers reported yesterday in Open Forum Infectious Diseases.
In the retrospective observational study, researchers from the University of Alabama at Birmingham analyzed data on previously healthy children ages 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 2 days with an antibiotic or discharged home with an antibiotic prescription—versus those who received 2 days of antibiotics or less or were discharged home with no antibiotics.
The outcomes of interest were 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 2 days of antibiotics or were discharged with antibiotics. Fifty-six children received 2 days or less of antibiotics and none at discharge, with 32 receiving no antibiotics at all. There were no statistically significant differences in sex, race, or ethnicity between groups. Similar proportions of patients in both groups required intensive care unit admission, and there were no statistically significant differences between the groups in median hospital length or 30-day readmissions.
The proportion of patients treated with antibiotics decreased from 88% in the early part of the study period (2011 through 2013) to 66% from 2017 through 2019.
"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," they concluded. "This conclusion is also relevant for the outpatient setting, where most young children with community-acquired pneumonia are managed. Better tools for identifying those that require antibiotics will make it possible to achieve a significant advance in antibiotic stewardship."
Mar 9 Open Forum Infect Dis abstract
Global flu activity continues to decline
A new global flu update from the World Health Organization (WHO) shows declining activity in most world regions but increased H3N2 activity was reported in parts of South America.
Of respiratory samples that tested positive at national flu labs in the middle 2 weeks of February, 68.6% were influenza A. Of subtyped influenza A viruses, 88.9% were H3N2. Of the type B viruses for which lineage was determined, 100% belonged to the B-Victoria lineage.
In North America and Europe, influenza detections remained low and were predominantly A (H3N2) among those detected and subtyped. Respiratory syncytial virus (RSV) activity also decreased in the United States and Canada, the WHO said, with very little RSV noted in Europe.
Influenza B detections continued to drop in China and other parts of East Asia, though RSV activity was elevated in Mongolia and the Republic of Korea.
"The current influenza surveillance data should be interpreted with caution as the ongoing COVID-19 pandemic has influenced to varying extents health seeking behaviors, staffing/routines in sentinel sites, as well as testing priorities and capacities in Member States," the WHO warned.
Mar 7 WHO update