- Residual pneumonia can be treated with oral antibiotic
therapy instead of intravenous method
- 3.2% failure rate in intravenous method of drug
delivery while treating children discharged from the hospital with 7.1%
risk of complication.
- 2.6% failure rate in children on oral antibiotics with
0.6% adverse drug reaction.
A team of
researchers from Cincinnati Children's Hospital Medical Centre have found that
children who are recovering from complex pneumonia
can be treated with oral antibiotics.
The oral antibiotics are a replacement to intravenous antibiotics that are
generally prescribed to children during the recovery period when they are
discharged home from the hospital.
Among children with
complex pneumonia, intravenous antibiotics
are prescribed as a method of drug delivery for a period that ranges between 1
to 3 weeks during hospitalization, after which the child is normally, advised
intravenous antibiotics even after discharge.
‘Oral antibiotics are effective for residual pneumonia.’
Now, however, the
researchers claim that after intravenous antibiotics are administered during
the period of hospitalization, children could be shifted to oral antibiotics on
discharge from the hospital.
A retrospective study
was conducted on 2,123 children across 36 hospitals and it was found that oral antibiotics
were as effective as intravenous antibiotics in managing residual pneumonia in
Limitations of Using Intravenous Antibiotics
- Chances of infection at the site of injection are high
- Flow rates need to be monitored diligently: Exceeding the
flow rates could lead to complications.
- Children may move or shake during intravenous
antibiotic therapy at home, resulting in injury
- Intravenous antibiotic therapy would require careful
monitoring at home and sterile environment.
A child with residual
disease and on oral antibiotics will be able to get back to normal routine
faster than if intravenous antibiotics are administered at home. Moreover, the
risk of complications during intravenous injections might require repeat
Dr. Samir Shah who is
the lead author of the study said "PICC line complications can be serious,
resulting in hospital readmission, additional procedures, and more medications,
as well as missed work or school." Cincinnati Children's Director of Hospital
Medicine, Dr. Shah further added "It's not surprising that children and
families would rather not use PICC lines. Our findings, which provide
compelling evidence to support the use of oral antibiotics for children with
complex pneumonia, will contribute to safer care for children across the
The prevalence of
complex pneumonia is 15%, with these children requiring hospital care for a
period of three weeks. After discharge, there is considerable variation in the
prescribed medical care routine. Three fourth of the study participants were
children who received intravenous antibiotics during hospitalization for
2,123 children were
included in the study:
- 281 children, 13.6% of the children were prescribed
intravenous antibiotics after they were discharged.
- 3.2% failure rate was noticed among children on a
peripherally inserted central venous catheter (PICC) line
- 2.6% failure rate was noticed among children on oral
- PICC associated complications were seen in 7.1% of the
- Drug related complications were seen in 0.6% of
patients on oral antibiotics.
Complex pneumonia is a
condition in which there is collection of fluid in the pleural space during an
underlying infection of pneumonia. In
some cases there is pus in the pleural membrane. This type of complex pneumonia
is generally seen in 6 to 8% of community acquired pneumonia.
The most common cause of
community acquired pneumonia is Streptococcus pneumonia.
microorganisms that are known to cause this infection, but to a lesser extent,
are Staphylococcus aureus, Mycobacterium tuberculosis and Helicobacter Sp.
Staphylococcus aureus is
known to cause a more severe necrotizing form of disease along with increased
- Complicated Pneumomnia - (http://peds.stanford.edu/Rotations/blue_team/documents/Complicated_Pneumonia_Info.pdf)
- CT and MR Angiography: Comprehensive Vascular Assessment; Geoffrey D Rubin et al;