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Trends in Use of Postdischarge Intravenous Antibiotic Therapy for Children
Author(s) -
Fenster Michael E,
Hersh Adam L,
Srivastava Rajendu,
Keren Ron,
Wilkes Jacob,
Coon Eric R
Publication year - 2020
Publication title -
journal of hospital medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.128
H-Index - 65
eISSN - 1553-5606
pISSN - 1553-5592
DOI - 10.12788/jhm.3422
Subject(s) - medicine , intravenous therapy , pneumonia , osteomyelitis , intravenous antibiotics , antibiotics , hospital medicine , intensive care medicine , surgery , pediatrics , microbiology and biotechnology , biology
Children with complicated appendicitis, osteomyelitis, and complicated pneumonia have historically been treated with postdischarge intravenous antibiotics (PD‐IV) using peripherally inserted central catheters (PICCs). Recent studies have shown no advantage and increased complications of PD‐IV, compared with oral therapy, and the extent to which use of PD‐IV has since changed for these conditions is not known. We used a national children's hospital database to evaluate trends in PD‐IV during 2000‐2018 for each of these three conditions. PD‐IV decreased from 13% to 2% (risk ratio [RR], 0.15; 95% CI, 0.14‐0.16) for complicated appendicitis, 61% to 22% (RR, 0.41; 95% CI, 0.39‐0.43) for osteomyelitis, and 29% to 19% (RR, 0.63; 95% CI, 0.58‐0.69) for complicated pneumonia. Despite these overall reductions, substantial variation in PD‐IV use by hospital remains in 2018.