Antimicrobial switch therapy in pediatric patients hospitalized by uncomplicated community-acquired pneumonia

Objective: To evaluate the duration of intravenous (IV) antibiotic therapy and the practice of switch therapy to oral in the treatment of children aged 2 months to 5 years with uncomplicated severe community acquired pneumonia (CAP) in a pediatric public hospital. Methods: Retrospective, observatio...

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Autores principales:	Ronaldo MORALES-JUNIOR, Anna C. BARRIENTOS, Raquel M. SCALCO, Aline G. FEVEREIRO, Sulim ABRAMOVICI, Camila C. CAMPIONI
Formato:	article
Lenguaje:	EN PT
Publicado:	Sociedade Brasileira de Farmácia Hospitalar e Serviços de Saúde 2020
Materias:	Public aspects of medicine RA1-1270 Pharmacy and materia medica RS1-441 Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/ce3a9e0544bc47b19bd712f56576d9ba
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spelling	oai:doaj.org-article:ce3a9e0544bc47b19bd712f56576d9ba2021-11-28T02:44:55ZAntimicrobial switch therapy in pediatric patients hospitalized by uncomplicated community-acquired pneumonia10.30968/rbfhss.2020.113.04822179-59242316-7750https://doaj.org/article/ce3a9e0544bc47b19bd712f56576d9ba2020-08-01T00:00:00Zhttps://www.rbfhss.org.br/sbrafh/article/view/482https://doaj.org/toc/2179-5924https://doaj.org/toc/2316-7750 Objective: To evaluate the duration of intravenous (IV) antibiotic therapy and the practice of switch therapy to oral in the treatment of children aged 2 months to 5 years with uncomplicated severe community acquired pneumonia (CAP) in a pediatric public hospital. Methods: Retrospective, observational and cross-sectional study in which patients who started IV ampicillin treatment were selected. The patients were classified as “eligible” or “ineligible” to undergo switch therapy after 48 and 72 hours of hospitalization according to clinical criteria. Patients with length of stay <or ≥7 days were compared regarding demographic characteristics and antibiotic therapy, considering p <0.05 significant. Results: Eighty-six patients were evaluated, aged 14.4 (IQR: 10.8-22.7) months. The duration of IV therapy was 4 (IQR: 3-6) days; 56% of patients were classified as eligible for switch therapy within 48h and 74% as eligible within 72h. However, only 19 cases (22%) underwent switch therapy at the appropriate time. The main reason for the transition was the accidental loss of venous access (61%). The group with length of stay <7 days had a higher rate of switch and, consequently, shorter IV therapy duration (p <0.01). Conclusion: The switch therapy in the first 48 to 72 hours is not routinely used in the clinical practice in patients hospitalized with CAP. The findings warn of the need for institutional initiatives on this practice, aiming at improving the quality of care with shorter IV therapy duration and impact on length of hospital stay. Ronaldo MORALES-JUNIORAnna C. BARRIENTOSRaquel M. SCALCOAline G. FEVEREIROSulim ABRAMOVICICamila C. CAMPIONISociedade Brasileira de Farmácia Hospitalar e Serviços de SaúdearticlePublic aspects of medicineRA1-1270Pharmacy and materia medicaRS1-441Therapeutics. PharmacologyRM1-950ENPTRevista Brasileira de Farmácia Hospitalar e Serviços de Saúde, Vol 11, Iss 3 (2020)
institution	DOAJ
collection	DOAJ
language	EN PT
topic	Public aspects of medicine RA1-1270 Pharmacy and materia medica RS1-441 Therapeutics. Pharmacology RM1-950
spellingShingle	Public aspects of medicine RA1-1270 Pharmacy and materia medica RS1-441 Therapeutics. Pharmacology RM1-950 Ronaldo MORALES-JUNIOR Anna C. BARRIENTOS Raquel M. SCALCO Aline G. FEVEREIRO Sulim ABRAMOVICI Camila C. CAMPIONI Antimicrobial switch therapy in pediatric patients hospitalized by uncomplicated community-acquired pneumonia
description	Objective: To evaluate the duration of intravenous (IV) antibiotic therapy and the practice of switch therapy to oral in the treatment of children aged 2 months to 5 years with uncomplicated severe community acquired pneumonia (CAP) in a pediatric public hospital. Methods: Retrospective, observational and cross-sectional study in which patients who started IV ampicillin treatment were selected. The patients were classified as “eligible” or “ineligible” to undergo switch therapy after 48 and 72 hours of hospitalization according to clinical criteria. Patients with length of stay <or ≥7 days were compared regarding demographic characteristics and antibiotic therapy, considering p <0.05 significant. Results: Eighty-six patients were evaluated, aged 14.4 (IQR: 10.8-22.7) months. The duration of IV therapy was 4 (IQR: 3-6) days; 56% of patients were classified as eligible for switch therapy within 48h and 74% as eligible within 72h. However, only 19 cases (22%) underwent switch therapy at the appropriate time. The main reason for the transition was the accidental loss of venous access (61%). The group with length of stay <7 days had a higher rate of switch and, consequently, shorter IV therapy duration (p <0.01). Conclusion: The switch therapy in the first 48 to 72 hours is not routinely used in the clinical practice in patients hospitalized with CAP. The findings warn of the need for institutional initiatives on this practice, aiming at improving the quality of care with shorter IV therapy duration and impact on length of hospital stay.
format	article
author	Ronaldo MORALES-JUNIOR Anna C. BARRIENTOS Raquel M. SCALCO Aline G. FEVEREIRO Sulim ABRAMOVICI Camila C. CAMPIONI
author_facet	Ronaldo MORALES-JUNIOR Anna C. BARRIENTOS Raquel M. SCALCO Aline G. FEVEREIRO Sulim ABRAMOVICI Camila C. CAMPIONI
author_sort	Ronaldo MORALES-JUNIOR
title	Antimicrobial switch therapy in pediatric patients hospitalized by uncomplicated community-acquired pneumonia
title_short	Antimicrobial switch therapy in pediatric patients hospitalized by uncomplicated community-acquired pneumonia
title_full	Antimicrobial switch therapy in pediatric patients hospitalized by uncomplicated community-acquired pneumonia
title_fullStr	Antimicrobial switch therapy in pediatric patients hospitalized by uncomplicated community-acquired pneumonia
title_full_unstemmed	Antimicrobial switch therapy in pediatric patients hospitalized by uncomplicated community-acquired pneumonia
title_sort	antimicrobial switch therapy in pediatric patients hospitalized by uncomplicated community-acquired pneumonia
publisher	Sociedade Brasileira de Farmácia Hospitalar e Serviços de Saúde
publishDate	2020
url	https://doaj.org/article/ce3a9e0544bc47b19bd712f56576d9ba
work_keys_str_mv	AT ronaldomoralesjunior antimicrobialswitchtherapyinpediatricpatientshospitalizedbyuncomplicatedcommunityacquiredpneumonia AT annacbarrientos antimicrobialswitchtherapyinpediatricpatientshospitalizedbyuncomplicatedcommunityacquiredpneumonia AT raquelmscalco antimicrobialswitchtherapyinpediatricpatientshospitalizedbyuncomplicatedcommunityacquiredpneumonia AT alinegfevereiro antimicrobialswitchtherapyinpediatricpatientshospitalizedbyuncomplicatedcommunityacquiredpneumonia AT sulimabramovici antimicrobialswitchtherapyinpediatricpatientshospitalizedbyuncomplicatedcommunityacquiredpneumonia AT camilaccampioni antimicrobialswitchtherapyinpediatricpatientshospitalizedbyuncomplicatedcommunityacquiredpneumonia
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Antimicrobial switch therapy in pediatric patients hospitalized by uncomplicated community-acquired pneumonia

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