Comparison of antibiotic use in children admitted to either the respiratory ward or the ICU with pneumonia
| In-hospital antibiotic use | Respiratory ward* (n=2824) | ICU (n=87) | P value† | ||
| N (%) | Days (median, IQR) | N (%) | Days (median, IQR) | ||
| Antibiotic used | 2767 (98.0) | 6.0 (5.0–8.0) | 86 (98.9) | 8.0 (7.0–14.0) | >0.05 |
| Oral antibiotic only d | |||||
| Total | n=2354 | – | n=6 | – | |
| Cefuroxime‡ | 1297 (55.1) | 6.0 (4.0–7.0) | 3 (50.0) | 3.0 (2.0–4.0) | >0.05§ |
| Amoxicillin | 39 (1.7) | 5.0 (4.0–7.0) | 0 | – | >0.05§ |
| Amoxi/clav | 973 (41.3) | 5.0 (4.0–7.0) | 1 (16.7) | 5.0 | >0.05§ |
| Macrolide | 752 (32.0) | – | 3 (50.0) | – | |
| Erythromycin | 39 (1.7) | 6.0 (4.0–8.0) | 2 (33.3) | 6.0 | <0.05§ |
| Azi/clarithromycin | 713 (30.3) | 5.0 (4.0–5.0) | 1 (16.7) | 5.0 | >0.05§ |
| Intravenous antibiotic only ¶ | |||||
| Total | n=180 | – | n=47 | – | |
| Ampicillin | 65 (36.1) | 7.0 (6.0–7.0) | 10 (21.3) | 7.0 (4.8–8.0) | >0.05 |
| Cephalosporin third generation | 110 (61.1) | – | 36 (76.6) | – | |
| Cefotaxime | 80 (44.4) | 7.0 (6.0–8.0) | 21 (44.7) | 7.0 (6.5–9.5) | >0.05 |
| Ceftriaxone | 28 (15.6) | 8.0 (7.0–10.0) | 6 (12.8) | 6.0 (4.5–10.0) | >0.05 |
| Ceftazidime | 2 (1.1) | 8.5 (8.0–9.0) | 9 (19.1) | 8.0 (7.0–12.0) | <0.001 |
| Vancomycin | 8 (4.4) | 10.0 (7.3–16.0) | 8 (17.0) | 14.0 (9.3–19.8) | <0.01 |
| Clindamycin | 0 | – | 2 (4.3) | 15.0 (10.0–20.0) | <0.05§ |
| Imipenem/cilastatin | 3 (1.7) | 10.0 (8.0–12.0) | 6 (12.8) | 15.5 (14.0–21.0) | <0.01 |
| Ticarcillin | 4 (2.2) | 9.5 (7.5–13.8) | 0 | – | >0.05§ |
| Other¶ | 5 (2.8) | 6.0 (4.0–8.8) | 3 (6.5) | 9.0 (8.0–13.5) | >0.05§ |
| Intravenous and then oral antibiotic | |||||
| Total | n=71 | 9.0 (8.0–12.0) | n=24 | 11.0 (8.0–18.0) | – |
| Oral and then intravenous antibiotic | |||||
| Total | n=162 | 12.0 (10.0–15.0) | n=9 | 23.0 (13.0–29.5) | – |
*Patients admitted to the respiratory ward and then transferred to the ICU were included among ‘respiratory ward’ patients in the comparative analysis.
†Using χ2 test to compare proportions between departments.
‡Mostly cefuroxime (second-generation cephalosporin), with only limited third-generation (cefixime) use.
§Using Fisher’s extract test; the total add to more than N (>100%), since some children received more than one antibiotic at the same time.
¶Including ampicillin+sulbactam, cefoperazone, ticarcillin+clavulanic acid, ciprofloxacin, levofloxacin, linezolid, colistin, meropenem, metronidazole, piperacillin±tazobactam; antivirals and antifungals were not considered.
Amoxi/clav, amoxicillin with clavulanic acid; azi, azithromycin; ICU, intensive care unit.