Antibiotic Use and Treatment Outcomes among Children with Community-Acquired Pneumonia Admitted to a Tertiary Care Public Hospital in Nepal.

Abstract

In the era of growing antimicrobial resistance, there is a concern about the effectiveness of first-line antibiotics such as ampicillin in children hospitalized with community-acquired pneumonia. In this study, we describe antibiotic use and treatment outcomes among under-five children with community-acquired pneumonia admitted to a tertiary care public hospital in Nepal from 2017 to 2019. In this cross-sectional study involving secondary analysis of hospital data, there were 659 patients and 30% of them had a history of prehospital antibiotic use. Irrespective of prehospital antibiotic use, ampicillin monotherapy (70%) was the most common first-line treatment provided during hospitalization followed by ceftriaxone monotherapy (12%). The remaining children (18%) were treated with various other antibiotics alone or in combination as first-line treatment. Broad-spectrum antibiotics such as linezolid, vancomycin, and meropenem were used in less than 1% of patients. Overall, 66 (10%) children were required to switch to second-line treatment and only 7 (1%) children were required to switch to third-line treatment. Almost all (99%) children recovered without any sequelae. This study highlights the effectiveness of ampicillin monotherapy in the treatment of community-acquired pneumonia in hospitalized children in a non-intensive care unit setting.

• Authors: Bhishma Pokhrel, Tapendra Koirala, Dipendra Gautam, Ajay Kumar, Bienvenu Salim Camara, Saw Saw, Sunil Kumar Daha, Sunaina Gurung, Animesh Khulal, Sonu Kumar Yadav, Pinky Baral, Meeru Gurung, Shrijana Shrestha
• Journal: Tropical medicine and infectious disease (Trop Med Infect Dis) Vol. 6 Issue 2 (Apr 20 2021) ISSN: 2414-6366 [Electronic] Switzerland
• PMID: 33923973 (Publication Type: Journal Article)