Ching-Ying Huang1, Lung Chang1, Ching-Chuan Liu2, Yhu-Chering Huang3, Luan-Yin Chang4, Yi-Chuan Huang5, Nan-Chang Chiu6, Hsiao-Chuan Lin7, Yu-Huai Ho8, Hsin Chi9, Li-Min Huang10. 1. Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan. 2. Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan. 3. Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan. 4. Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan. 5. Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan. 6. Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Medicine, Nursing and Management College, Taipei, Taiwan. 7. Department of Pediatrics, China Medical University Hospital, Taichung, Taiwan. 8. Division of Infectious Disease, Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan. 9. Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Medicine, Nursing and Management College, Taipei, Taiwan. Electronic address: chi.4531@ms1.mmh.org.tw. 10. Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: lmhuang@ntu.edu.tw.
Abstract
BACKGROUND: Complications regarding pneumonia occur in children during hospitalization and treatment. The objective of this study is to identify the risk factors of progressive pneumonia in order to institute early appropriate therapy. METHODS: This was a prospective study which involved the pediatric departments of seven medical centers in Taiwan. Children aged from 6 weeks to 18 years old, hospitalized with community-acquired pneumonia (CAP) from January 2010 to August 2011, were enrolled. Progressive pneumonia was defined by the deterioration of discharge diagnosis as compared to admission. Demographic, clinical, and laboratory variables, diagnosis, antimicrobial therapy, and pathogens were compared. RESULTS: Four hundred and two children were included and 57 (14.2%) had progressive pneumonia. Independent associated factors identified for the development of progressive disease, by multivariate logistic regression analysis, included the following, age < 2 years, pleural effusion as admission diagnosis, Hb < 10 g/dL, WBC count > 17,500/μL, tachypnea, and duration to defervescence > 3 days. Streptococcus pneumoniae was the main etiology for progressive pneumonia (57.9%). There was no difference in choice of initial parenteral antibiotics between groups of progressive and non-progressive pneumococcal pneumonia. CONCLUSION: We found six clinical factors for predicting progressive pneumonia. Further evaluation should be performed in hospitalized pneumonic children with persistent fever not responding to therapy within 72 hours. The initial parenteral antibiotics were not related to the progression of pneumococcal pneumonia.
BACKGROUND: Complications regarding pneumonia occur in children during hospitalization and treatment. The objective of this study is to identify the risk factors of progressive pneumonia in order to institute early appropriate therapy. METHODS: This was a prospective study which involved the pediatric departments of seven medical centers in Taiwan. Children aged from 6 weeks to 18 years old, hospitalized with community-acquired pneumonia (CAP) from January 2010 to August 2011, were enrolled. Progressive pneumonia was defined by the deterioration of discharge diagnosis as compared to admission. Demographic, clinical, and laboratory variables, diagnosis, antimicrobial therapy, and pathogens were compared. RESULTS: Four hundred and two children were included and 57 (14.2%) had progressive pneumonia. Independent associated factors identified for the development of progressive disease, by multivariate logistic regression analysis, included the following, age < 2 years, pleural effusion as admission diagnosis, Hb < 10 g/dL, WBC count > 17,500/μL, tachypnea, and duration to defervescence > 3 days. Streptococcus pneumoniae was the main etiology for progressive pneumonia (57.9%). There was no difference in choice of initial parenteral antibiotics between groups of progressive and non-progressive pneumococcal pneumonia. CONCLUSION: We found six clinical factors for predicting progressive pneumonia. Further evaluation should be performed in hospitalized pneumonicchildren with persistent fever not responding to therapy within 72 hours. The initial parenteral antibiotics were not related to the progression of pneumococcal pneumonia.
Authors: Lauren McClain; Matthew Hall; Samir S Shah; Joel S Tieder; Angela L Myers; Katherine Auger; Angela M Statile; Karen Jerardi; Mary Ann Queen; Evan Fieldston; Derek J Williams Journal: J Hosp Med Date: 2014-06-18 Impact factor: 2.960
Authors: Jennifer L Lenahan; Evangelyn Nkwopara; Melda Phiri; Tisungane Mvalo; Mari T Couasnon; Kali Turner; Chifundo Ndamala; Eric D McCollum; Susanne May; Amy Sarah Ginsburg Journal: ERJ Open Res Date: 2020-05-26