Evidence map›Paper›PMID 42944981›Full record

ArticlePulmonary therapy2026

The Impact of Antibiotic Initiation Timing in Children with Severe Community-Acquired Pneumonia: A Post-Hoc Analysis of an Observational Study.

Sin Wee Loh, Judith Ju-Ming Wong, Qalab Abbas, Suresh Kumar Angurana, Hwa Jin Cho, Hongxing Dang, Pustika Efar, Phuc Huu Phan, Pei Chuen Lee, Chunfeng Liu and 8 more

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

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1 · What the graph read from it

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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

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5 · Who and what money

Authors and funding

18 authors.

Sin Wee LohChildren's Intensive Care Unit, Department of Paediatric Subspecialties, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore. xinweiloh87@gmail.com.ORCID http://orcid.org/0000-0002-0321-8991
Judith Ju-Ming WongChildren's Intensive Care Unit, Department of Paediatric Subspecialties, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore.
Qalab AbbasAga Khan University Hospital, Karachi, Pakistan.
Suresh Kumar AnguranaPost Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India.
Hwa Jin ChoChonnam National University Children's Hospital and Medical School, Gwangju, South Korea.
Hongxing DangChildren's Hospital of Chongqing Medical University, Chongqing, China.
Pustika EfarHarapan Kita Women's and Children's Hospital, West Jakarta, Indonesia.
Phuc Huu PhanVietnam National Children's Hospital, Hanoi, Vietnam.
Pei Chuen LeeUniversity Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia.
Chunfeng LiuShengjing Hospital of China Medical University, Shenyang, China.
Lijia FanNational University Hospital, Singapore, Singapore.
Minchaya PukdeetraipopKing Chulalongkorn Memorial Hospital, Bangkok, Thailand.
Justin Qi Yuee WangUniversity Malaya Medical Centre, Kuala Lumpur, Malaysia.
Saptadi YuliartoSaiful Anwar Hospital, Malang, Indonesia.
Mary Xuemei ZhuChildren's Hospital of Fudan University, Shanghai, China.
Rehena SultanaCentre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore.
Jan Hau LeeChildren's Intensive Care Unit, Department of Paediatric Subspecialties, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore.
Paediatric Acute Critical Care Asian Network (PACCMAN)

Funding

SingHealth AM/TP003/2018
6 · The paper itself

Abstract

introductionThe aim of this study was to examine the association between early antibiotic initiation and clinical outcomes in children admitted to the paediatric intensive care unit (PICU) with severe community-acquired pneumonia (CAP).

methodsWe conducted a post-hoc analysis of a multicentre observational study across nine Asian PICUs. Children with severe CAP were categorized into early (≤ 6 h) or late (> 6 h) antibiotic initiation groups (early and late antibiotic groups, respectively) relative to PICU admission. The primary outcome was PICU mortality; secondary outcomes were 28-day ventilation-free days (VFD) and intensive care unit-free days (IFD). Multivariable analyses adjusted for country as fixed effect, age, Paediatric Index of Mortality 3 (PIM 3) score and comorbidities, when feasible.

resultsAmong the 544 paediatric patients included in the analysis, median age was 14.0 [interquartile range (IQR) 4.0-34.0] months and the PIM 3 score was 0.3 (IQR 0.0-6.8) %. Viral and bacterial pathogens were isolated in 206 (37.9%) and 145 (26.7%) patients, respectively. Almost all patients [537 (98.7%)] received antibiotics, with 475 (87.3%) and 62 (11.4%) patients in the early and late antibiotic groups, respectively. Late antibiotic initiation was associated with higher PICU mortality [adjusted odds ratio (aOR) 5.19, 95% confidence interval (CI) 1.94-13.88, P < 0.01], septic shock requiring inotropic support (aOR 3.25, 95% CI 1.45-7.28, P < 0.01) and multi-organ failure (aOR 4.60, 95% CI 2.11-10.04, P < 0.01). No significant associations were observed between late antibiotic initiation and VFD or IFD.

conclusionIn critically ill children with severe CAP, initiating antibiotics within 6 h of PICU admission was associated with improved outcomes. This 6-h window may serve as a practical benchmark for quality improvement initiatives.

Indexed as

AntibioticsCommunity-acquired pneumoniaPaediatric intensive care unitPaediatricsPneumonia

Identifiers

PMID42944981

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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.