Don’t use broad-spectrum antibiotics such as ceftriaxone for children hospitalized with uncomplicated CAP. Use narrow-spectrum antibiotics such as penicillin, ampicillin, or amoxicillin.

Rationale and Comments

Using broad-spectrum antibiotic therapy does not improve rates of treatment failure, improve length of stay, or decrease costs when compared with narrow-spectrum antibiotic therapy for children hospitalized with CAP. The use of narrow-spectrum antibiotics for children hospitalized with CAP can limit the development of multidrug-resistant organisms, while achieving similar or better outcomes.

Sponsoring Organizations

• Society of Hospital Medicine (Pediatric)
• American Academy of Pediatrics
• Academic Pediatric Association

Sources

• Retrospective cohort study

Disciplines

• Infectious disease
• Pediatric
• Pulmonary medicine

References

• Bradley JS, et al.; Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. The management of community-acquired pneumonia in infants and children older than 3 months of age: clinical practice guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. Clin Infect Dis. 2011;53(7):e25-76.
  
• Williams DJ, et al. Narrow vs broad-spectrum antimicrobial therapy for children hospitalized with pneumonia. Pediatrics. 2013;132(5):e1141-1148.
  
• Queen MA, et al. Comparative effectiveness of empiric antibiotics for community-acquired pneumonia. Pediatrics. 2014;133(1):e23-29.
  
• Thomson J, et al. Hospital outcomes associated with guideline-recommended antibiotic therapy for pediatric pneumonia. J Hosp Med. 2015;10(1):13-18.