First name
Richard
Last name
Ruddy

Title

Developing Consensus on Clinical Outcomes for Children with Mild Pneumonia: A Delphi Study.

Year of Publication

2023

Date Published

01/2023

ISSN Number

2048-7207

Abstract

BACKGROUND: The absence of consensus for outcomes in pediatric antibiotic trials is a major barrier to research harmonization and clinical translation. We sought to develop expert consensus on study outcomes for clinical trials of children with mild community-acquired pneumonia (CAP).

METHODS: Applying the Delphi method, a multispecialty expert panel ranked the importance of various components of clinical response and treatment failure outcomes in children with mild CAP for use in research. During Round 1, panelists suggested additional outcomes in open-ended responses that were added to subsequent rounds of consensus building. For Rounds 2 and 3, panelists were provided their own prior responses and summary statistics for each item in the previous round. The consensus was defined by >70% agreement.

RESULTS: The expert panel determined that response to and failure of treatment should be addressed at a median of 3 days after initiation. Complete or substantial improvement in fever, work of breathing, dyspnea, tachypnea when afebrile, oral intake, and activity should be included as components of adequate clinical response outcomes. Clinical signs and symptoms including persistent or worsening fever, work of breathing, and reduced oral intake should be included in treatment failure outcomes. Interventions including receipt of parenteral fluids, supplemental oxygen, need for high-flow nasal cannula oxygen therapy, and change in prescription of antibiotics should also be considered in treatment failure outcomes.

CONCLUSIONS: Clinical response and treatment failure outcomes determined by the consensus of this multidisciplinary expert panel can be used for pediatric CAP studies to provide objective data translatable to clinical practice.

DOI

10.1093/jpids/piac123

Alternate Title

J Pediatric Infect Dis Soc

PMID

36625856

Title

Diagnostic Testing and Antibiotic Use in Young Children With Community-Acquired Pneumonia in the United States, 2008-2015.

Year of Publication

2019

Date Published

2019 May 20

ISSN Number

2048-7207

Abstract

<p>Diagnostic testing and antibiotics are not routinely recommended for young children with community-acquired pneumonia. In a national sample of &gt;6 million outpatient 1- to 6-year-olds with community-acquired pneumonia between 2008 and 2015, a complete blood count was obtained for 8.6% (95% confidence interval [CI], 6.1%-11.1%), radiography was performed for 43% (95% CI, 36%-50%), and antibiotics were given for 73.9% (95% CI, 67.1%-80.7%). There were no changes in testing or antibiotic use over time.</p>

DOI

10.1093/jpids/piz026

Alternate Title

J Pediatric Infect Dis Soc

PMID

31107533

WATCH THIS PAGE

Subscription is not available for this page.