Children with pneumonia: how do they present and how are they managed?

Clark, Julia E., Hammal, Donna, Spencer, David and Hampton, Fiona (2007) Children with pneumonia: how do they present and how are they managed?. Archives of Disease in Childhood, 92 5: 394-398. doi:10.1136/adc.2006.097402


Author Clark, Julia E.
Hammal, Donna
Spencer, David
Hampton, Fiona
Title Children with pneumonia: how do they present and how are they managed?
Journal name Archives of Disease in Childhood   Check publisher's open access policy
ISSN 0003-9888
1468-2044
Publication date 2007-05-01
Year available 2007
Sub-type Article (original research)
DOI 10.1136/adc.2006.097402
Open Access Status Not yet assessed
Volume 92
Issue 5
Start page 394
End page 398
Total pages 5
Place of publication London, United Kingdom
Publisher B M J Group
Language eng
Formatted abstract
Objective: To describe the spectrum of clinical features and management of community acquired pneumonia in the UK.

Design: Prospectively recorded clinical details for all children with possible pneumonia and chest x ray (CXR) changes in 13 hospitals in the North of England between 2001 and 2002.

Results: 89% of 711 children presenting to hospital with pneumonia were admitted; 96% received antibiotics, 70% intravenously. 20% had lobar CXR changes, 3% empyema and 4% required intensive care. Respiratory rate (RR), hypoxia and dyspnoea all correlated with each other and prompted appropriate interventions. Admission in children, not infants, was independently associated with RR, oxygen saturation, lobar CXR changes and pyrexia. Neither C-reactive protein, lobar CXR changes or pyrexia were associated with severity. Children over 1 year old with perihilar CXR changes more often had severe disease (p = 0.001). Initial intravenous antibiotics were associated with lobar CXR changes in infants and children and with dyspnoea, pyrexia and pleural effusion in children. The presence of pleural effusion increased duration of antibiotic treatment (p<0.001). Cefuroxime was the most often used intravenous antibiotic in 61%. Oral antibiotics included a penicillin in 258 (46%), a macrolide in 192 (34%) and a cephalosporin in 117 (21%). Infants stayed significantly longer (p<0.001) as did children with severe disease (p<0.01), effusions (p = 0.005) or lobar CXR changes (p ≤ 0.001).

Conclusions: There is a high rate of intravenous antibiotic administration in hospital admissions for pneumonia. Despite lobar CXR changes not being independently associated with severe disease, initial lobar CXR changes and clinical assessment in children independently influenced management decisions, including admission and route of antibiotics.
Keyword Pediatrics
Pediatrics
PEDIATRICS
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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