Evidence map›Paper›PMID 42142027›Full record

ArticlePediatric pulmonology2026

Early Antibiotic Discontinuation for Children With a Positive Rapid Respiratory Viral Test Hospitalized for Suspected Bacterial Tracheostomy-Associated Infections.

Christopher J Russell, Naoko Kono, Margaret Rush, Andrea Hahn, Catherine S Forster, Jonathan D Cogen, Sarah Hofman DeYoung, John M Morrison, Joanna Thomson, Sukhada Vaidya Mairal and 4 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Pediatric pulmonology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

14 authors.

Christopher J RussellDivision of Pediatric Hospital Medicine, Department of Pediatrics, Stanford University, Palo Alto, California, USA.ORCID https://orcid.org/0000-0002-5269-7861
Naoko KonoDepartment of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Margaret RushDivision of Hospital Medicine, Children's National Hospital, Washington, DC, USA.
Andrea HahnDepartment of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Catherine S ForsterDepartment of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Jonathan D CogenDivision of Pulmonary and Sleep Medicine, Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, Washington, USA.
Sarah Hofman DeYoungDivision of Pulmonary and Sleep Medicine, Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, Washington, USA.
John M MorrisonDivision of Pediatric Hospital Medicine, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA.ORCID https://orcid.org/0000-0003-2882-8849
Joanna ThomsonDivision of Hospital Medicine and James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.ORCID https://orcid.org/0000-0002-7538-0998
Sukhada Vaidya MairalDivision of Pediatric Hospital Medicine, Department of Pediatrics, Stanford University, Palo Alto, California, USA.
Wendy J MackDepartment of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Michael N NeelyDivision of Infectious Diseases, Children's Hospital Los Angeles, Los Angeles, California, USA.
Tamara D SimonDepartment of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Pediatric Research in Inpatient Settings Network

Funding

Stanford Center for Clinical and Translational Research and EducationUM1TR004921 · NCATS · STANFORD UNIVERSITY · PI MANISHA DESAI, DEAN W FELSHER · 2024 to 2026
$30.1M
AHRQ HHS 1R01HS027619National Center for Advancing Translational Science (NCATS) UL1TR001855National Center for Advancing Translational Science (NCATS) UL1TR003142National Center for Advancing Translational Science (NCATS) UM1TR004921National Heart, Lung, and Blood Institute, National Institutes of Health 1K23HL163331NCATS NIH HHS UM1 TR004921
6 · The paper itself

Abstract

objectiveTest the association between early antibiotic discontinuation and outcomes for children with a tracheostomy and positive respiratory viral PCR (RVP) hospitalized with suspected bTRAIN (bacterial TRacheostomy-Associated INfection; pneumonia/tracheitis).

methodsWe conducted a multicenter cohort study between September 1, 2021 and August 31, 2024 of children with pre-existing tracheostomy hospitalized for suspected bTRAIN (tracheal aspirate bacterial culture sent and bTRAIN antibiotics started) at six children's hospitals with: (1) a positive RVP test; (2) no antibiotic pre-treatment; and (3) length of stay (LOS) < 37 days (outlier). Mixed-effects regression models identified independent associations between early antibiotic discontinuation and our primary outcome, LOS (in days). Inverse probability treatment weighting based on propensity scoring adjusted for measured confounding. We explored the association between early antibiotic discontinuation and 3 secondary outcomes: late ICU transfer, in-hospital mortality, and 30-day bTRAIN rehospitalization rates.

resultsOf 542 hospitalizations in 365 children, the median admission age was 4 years (interquartile range [IQR]: 2-8 years). Common viruses included rhinovirus (n = 282; 52%), SARS-CoV-2 (n = 63; 12%), and respiratory syncytial virus (n = 61; 11%). The median LOS was 7 days (IQR: 5-11 days). Only 28% (n = 152) had early antibiotic discontinuation; full bTRAIN treatment was associated with a 23% (5%-45%) increased LOS, with estimated LOS means (95% CI) of 7.0 (5.8-8.4) days for early antibiotic discontinuation and 8.6 (7.8-9.4) days in the bTRAIN-treated group. Secondary outcome rates (late ICU transfer = 14.6%; in-hospital mortality = 0.9%; 30-day bTRAIN rehospitalization rate = 8.3%) were similar rates between both groups.

conclusionsGiven similar rates of serious outcomes in both groups, clinicians could consider early discontinuation of antibiotic treatment in children with suspected bTRAINs who have a positive RVP test.

Indexed as

Anti-Bacterial AgentsTracheostomyChildChild, PreschoolCohort StudiesFemaleHospitalizationHospital MortalityHumansInfantLength of StayMaleAnti-Bacterial Agents

Identifiers

PMID42142027
PMCPMC13179731

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

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.