Evidence map›Paper›PMID 40031991›Full record

ArticleHospital pediatrics2025

Guideline-Concordant Antibiotic Use in Children With Community-Acquired Pneumonia.

James W Antoon, Hui Nian, Jessica Todd, Krow Ampofo, Yuwei Zhu, Laura Sartori, Jakobi Johnson, Donald H Arnold, Justine Stassun, Andrew T Pavia and 2 more

Abstract readMulticenter Study
In one paragraph

Article in Hospital pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

James W AntoonDepartment of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee.
Hui NianDepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee.
Jessica ToddMeharry Medical College, Nashville, Tennessee.
Krow AmpofoDepartment of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah.
Yuwei ZhuDepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee.
Laura SartoriDepartment of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee.
Jakobi JohnsonDepartment of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee.
Donald H ArnoldDepartment of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee.
Justine StassunDepartment of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee.
Andrew T PaviaDepartment of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah.
Carlos G GrijalvaDepartment of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee.
Derek J WilliamsDepartment of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee.

Funding

Risk Stratification and Decision Support to Improve Care and Outcomes in Children with PneumoniaR01AI125642 · NIAID · VANDERBILT UNIVERSITY MEDICAL CENTER · PI WILLIAMS, DEREK J. · 2017 to 2021
$3.3M
Mentoring in transmission of influenza and strategies for preventionK24AI148459 · NIAID · VANDERBILT UNIVERSITY MEDICAL CENTER · PI GRIJALVA, CARLOS G · 2020 to 2024
$893k
Oseltamivir Use and Risk of Serious Neuropsychiatric Adverse Events in ChildrenK23AI168496 · NIAID · VANDERBILT UNIVERSITY MEDICAL CENTER · PI ANTOON, JAMES W · 2022 to 2025
$740k
AHRQ HHS R01 HS029331NIAID NIH HHS K23 AI168496NIAID NIH HHS K24 AI148459NIAID NIH HHS R01 AI125642
6 · The paper itself

Abstract

backgroundDespite national guidelines on appropriate antibiotic therapy, there is wide variation in antibiotic decision-making for children with community-acquired pneumonia. This study sought to determine prevalence and factors associated with guideline-concordant antibiotic use in children presenting with pneumonia to the emergency department (ED).

methodsWe enrolled children aged younger than 18 years presenting to the ED at 2 US children's hospitals between September 2017 and May 2019 with clinical and radiographic pneumonia. The primary outcome was guideline-concordant antibiotic use as defined by the 2011 Infectious Diseases Society of America pediatric pneumonia guideline and local expert consensus. Outcomes included proportion of antibiotic use and proportion of guideline-concordant treatment. We used multivariable logistic regression models to determine associations of comorbidities and functional limitations, clinical findings, and radiographic characteristics with overall antibiotic use and guideline-concordant treatment.

resultsAmong 772 included children, 573 received antibiotics (74.2%), and 441 (57.1%) received guideline-concordant antibiotic treatment. Antibiotic initiation was less likely in those with interstitial findings on chest radiograph (adjusted odds ratio [aOR], 0.14; 95% CI, 0.07-0.25) and negative results or nonperformance of viral testing (aOR, 0.39; 95% CI, 0.24-0.65). Guideline-concordant treatment was more likely in those with chest indrawing (aOR, 2.22; 95% CI, 1.34-3.66) and less likely in those with clinically significant effusion (aOR, 0.21; 95% CI, 0.06-0.76).

conclusionsAmong children presenting to the ED with pneumonia, more than 40% received treatment inconsistent with guideline recommendations. These observations underscore opportunities to improve appropriate antibiotic use in this population.

Indexed as

Anti-Bacterial AgentsCommunity-Acquired InfectionsGuideline AdherencePneumoniaPractice Patterns, Physicians'AdolescentChildChild, PreschoolCommunity-Acquired PneumoniaEmergency Service, HospitalFemaleHospitals, PediatricHumansInfantMalePractice Guidelines as TopicAnti-Bacterial Agents

Identifiers

PMID40031991
PMCPMC11957931

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.