Changing clinical practice: management of paediatric community-acquired pneumonia

Elemraid, Mohamed A., Rushton, Stephen P., Thomas, Matthew F., Spencer, David A., Eastham, Katherine M., Gennery, Andrew R. and Clark, Julia E. (2014) Changing clinical practice: management of paediatric community-acquired pneumonia. Journal of Evaluation in Clinical Practice, 20 1: 94-99. doi:10.1111/jep.12091


Author Elemraid, Mohamed A.
Rushton, Stephen P.
Thomas, Matthew F.
Spencer, David A.
Eastham, Katherine M.
Gennery, Andrew R.
Clark, Julia E.
Title Changing clinical practice: management of paediatric community-acquired pneumonia
Journal name Journal of Evaluation in Clinical Practice   Check publisher's open access policy
ISSN 1356-1294
1365-2753
Publication date 2014-02
Year available 2013
Sub-type Article (original research)
DOI 10.1111/jep.12091
Open Access Status DOI
Volume 20
Issue 1
Start page 94
End page 99
Total pages 6
Place of publication Chichester, West Sussex, United Kingdom
Publisher Wiley-Blackwell Publishing
Language eng
Formatted abstract
Rationale and aim: To compare clinical features and management of paediatric community-acquired pneumonia (PCAP) following the publication of UK pneumonia guidelines in 2002 with data from a similar survey at the same hospitals in 2001-2002 (pre-guidelines).

Methods: A prospective survey of 11 hospitals in Northern England was undertaken during 2008-2009. Clinical and laboratory data were recorded on children aged ≤16 years who presented with clinical and radiological features of pneumonia.

Results: 542 children were included. There was a reduction in all investigations performed (P < 0.001) except C-reactive protein (P = 0.448) between surveys. These included full blood count (76% to 61%); blood culture (70% to 53%) and testing of respiratory secretions for viruses (24% to 12%) and bacteria (18% to 8%). Compared to pre-guidelines, there was a reduction in the use of intravenous antibiotics as a proportion of the total prescribed from 47% to 36% (P < 0.001) and a change in the route of antibiotic administration with increasing preference for oral alone (16% pre-compared to 50% post-guidelines, P < 0.001).

Conclusion: Apart from the acute phase reactants that should not be measured routinely, these changes are in line with the guideline recommendations. Improvements in antibiotic use are possible and have implications for future antimicrobial stewardship programmes. Further work using cost-effectiveness analysis may also demonstrate a financial benefit to health services from adoption of guidelines.
Keyword Antibiotics
Antibiotics stewardship
Children
Investigations
Management guidelines
Pneumonia
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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