Antibiotic Utilization in Hospitalized Children with Bronchiolitis: A Prospective Study Investigating Clinical and Epidemiological Characteristics at a Secondary Hospital in Madrid (2004–2022)
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Study Procedures
2.3. Virological Study
2.4. Statistical Analysis
3. Results
3.1. Respiratory Virus Findings
3.2. Factors Associated with Antibiotic Prescription during Hospitalization
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Clinical Characteristic | N (%) |
---|---|
Age (months) * | 5.5 ± 6.7 |
Male | 984 (57%) |
Prematurity | 212 (12%) |
Temperature > 38 °C | 866 (51%) |
Fever duration (days) * | 2.7 ± 2.2 |
Highest temperature (°C) * | 38.6 ± 0.5 |
Hypoxia (SatO2 < 95%) | 1156 (67%) |
Hypoxia duration (days) * | 3.2 ± 2.5 |
Length hospital stay (days) * | 4.5 ± 2.9 |
Abnormal chest radiograph | 415 (24%) |
Antibiotic treatment | 229 (13%) |
PICU admission | 68 (4%) |
Leucocytes (cells/mm3) | 13,446 ± 9533 |
Serum C reactive protein (mg/L) * | 26.6 ± 39.0 |
Clinical Characteristics | Antibiotic Treatment N = 229 | No Antibiotic Treatment N = 1486 | p-Value | OR (95% CI) |
---|---|---|---|---|
Sex, male | 120 (52%) | 864 (58%) | 0.102 | 0.8 (0.6 to 1.0) |
Age (months) * | 7.3 ± 5.9 | 5.2 ± 6.7 | <0.001 | |
Age > 6 months | 113 (49%) | 437 (29%) | <0.001 | 2.3 (1.8 to 3.1) |
Prematurity | 29 (13%) | 183 (12%) | 0.881 | 1.0 (0.7 to 1.6) |
Fever > 38 °C | 191 (84%) | 675 (45%) | <0.001 | 6.2 (4.3 to 8.9) |
Duration of fever (days) * | 3.3 ± 3.1 | 2.4 ± 1.9 | <0.001 | |
Hypoxia | 183 (80%) | 973 (66%) | <0.001 | 2.1 (1.5 to 3.0) |
Duration of hypoxia (days) * | 3.8 ± 2.8 | 3.1 ± 2.4 | 0.001 | |
Length of hospital stay (days) * | 6.3 ±3.4 | 4.4 ± 2.8 | <0.001 | |
Infiltrate/atelectasis | 150 (72%) | 265 (29%) | <0.001 | 6.2 (4.4 to 8.7) |
PICU admission | 22 (10%) | 46 (3%) | <0.001 | 3.1 (1.8 to 5.3) |
Respiratory virus detection | 197 (86%) | 1293 (87%) | 0.599 | 0.9 (0.6 to 1.4) |
Viral coinfection | 81 (36%) | 372 (25%) | 0.001 | 1.6 (1.2 to 2.2) |
Respiratory syncytial virus infection | 134 (59%) | 843 (58%) | 0.636 | 1.1 (0.8 to 1.4) |
Rhinovirus infection | 67 (30%) | 413 (28%) | 0.660 | 1.1 (0.8 to 1.5) |
Adenovirus infection | 32 (14%) | 96 (7%) | <0.001 | 2.3 (1.5 to 3.6) |
Human metapneumovirus infection | 8 (4%) | 82 (6%) | 0.198 | 0.6 (0.3 to 1.3) |
Human bocavirus infection | 27 (12%) | 71 (5%) | <0.001 | 2.7 (1.7 to 4.2) |
Influenza infection | 5 (2%) | 45 (3%) | 0.476 | 0.7 (0.3 to 1.8) |
Parainfluenza virus infection | 8 (4%) | 93 (6%) | 0.096 | 0.5 (0.3 to 1.1) |
Leucocytes (cells/mm3) * | 15,046 ± 9349 | 12,940 ± 9694 | 0.008 | |
Serum C reactive protein (mg/L) * | 45.2 ± 52.6 | 20.1 ± 30.4 | <0.001 |
Clinical Characteristics | Chest X-ray Performed N = 1109 | Chest X-ray not Performed N = 605 | p-Value | OR (95% CI) |
---|---|---|---|---|
Sex, male | 610 (55%) | 373 (62%) | 0.006 | 0.8 (0.6 to 0.9) |
Age (months) * | 6.3 ± 7.5 | 4.0 ± 4.3 | <0.001 | |
Age > 6 months | 428 (39%) | 121 (20%) | <0.001 | 2.5 (2.0 to 3.2) |
Fever > 38 °C | 679 (61%) | 186 (31%) | <0.001 | 3.5 (2.9 to 4.4) |
Duration of fever (days) * | 2.9 ± 2.3 | 1.9 ± 1.5 | <0.001 | |
Hypoxia | 815 (74%) | 338 (56%) | <0.001 | 2.1 (1.7 to 2.6) |
Duration of hypoxia (days) * | 3.5 ± 2.8 | 2.6 ± 1.7 | 0.001 | |
Length of hospital stay (days) * | 5.2 ±3.2 | 3.6 ± 2. | <0.001 | |
PICU admission | 62 (6%) | 5 (0.9%) | < 0.001 | 6.8 (2.7 to 16.9) |
Adenovirus infection | 96 (9%) | 32 (5%) | <0.001 | 2.3 (1.5 to 3.6) |
Human bocavirus infection | 82 (8%) | 16 (3%) | <0.001 | 2.9 (1.7 to 5.1) |
Parainfluenza virus infection | 52 (5%) | 49 (8%) | 0.005 | 0.6 (0.4 to 0.8) |
Leucocytes (cells/mm3) * | 13,827 ± 10176 | 11,386 ± 4437 | <0.001 | |
Serum C reactive protein (mg/L) * | 28.7 ± 40.7 | 14.6 ± 19.5 | <0.001 |
Clinical Characteristics | Antibiotic Treatment N = 191 | No Antibiotic Treatment N = 675 | p-Value | OR (95% CI) |
---|---|---|---|---|
Sex, male | 106 (56%) | 366 (54%) | 0.755 | 1.1 (0.8 to 1.5) |
Age (months) * | 7.8 ± 5.9 | 6.5 ± 6.3 | 0.016 | |
Prematurity | 19 (10%) | 61 (9%) | 0.701 | 1.1 (0.6 to 1.9) |
Duration of fever (days) * | 3.4 ± 3.1 | 2.4 ± 1.9 | <0.001 | |
Hypoxia | 153 (81%) | 483 (72%) | 0.015 | 1.6 (1.1 to 2.4) |
Duration of hypoxia (days) * | 3.8 ± 2.8 | 3.1 ± 2.3 | 0.001 | |
Length of hospital stay (days) * | 6.1 ±3.4 | 4.7 ± 2.7 | <0.001 | |
Infiltrate/atelectasis | 132 (74%) | 176 (35%) | <0.001 | 5.2 (3.5 to 7.6) |
PICU admission | 14 (7%) | 17 (3%) | 0.003 | 2.9 (1.4 to 6.0) |
Respiratory virus detection | 162 (86%) | 597 (90%) | 0.104 | 0.7 (0.4 to 1.1) |
Leucocytes (cells/mm3) * | 15,125 ± 9564 | 13,409 ± 11,265 | 0.086 | |
Serum C reactive protein (mg/L) * | 49.1 ± 54 | 21.5 ± 22.3 | <0.001 |
Clinical Characteristics | Antibiotic Treatment N = 22 | No Antibiotic Treatment N = 46 | p-Value | OR (95% CI) |
---|---|---|---|---|
Sex, male | 11 (50%) | 26 (57%) | 0.613 | 0.8 (0.3 to 2.1) |
Age (months) * | 4.1 ± 6.0 | 2.9 ± 4.0 | 0.316 | |
Prematurity | 6 (27%) | 9 (20%) | 0.473 | 1.5 (0.5 to 5.1) |
Fever > 38 °C | 14 (67%) | 17 (37%) | 0.024 | 3.4 (1.2 to 10.1) |
Duration of fever (days) * | 2.4 ± 1.9 | 1.5 ± 0.8 | 0.074 | |
Duration of hypoxia (days) * | 7.5 ± 4.4 | 5.4 ± 3.2 | 0.050 | |
Length of hospital stay (days) * | 9.3 ± 5.7 | 7.4 ± 4.9 | 0.169 | |
Length of PICU stay (days) * | 5.6 ± 4.2 | 2.2 ± 2.4 | 0.029 | |
Mechanic ventilation | 3 (50%) | 7 (54%) | 0.876 | 0.9 (0.1 to 5.9) |
Infiltrate/atelectasis | 13 (65%) | 17 (41%) | 0.071 | 2.7 (0.9 to 8.3) |
Leucocytes (cells/mm3) * | 16,367 ± 8547 | 14,615 ± 11,865 | 0.560 | |
Serum C reactive protein (mg/L) * | 57.1 ± 50.1 | 14.8 ± 17.7 | <0.001 |
Clinical Characteristic | p-Value | Adjusted OR 95% CI |
---|---|---|
Temperature > 38 °C | <0.001 | 3.1 (1.8 to 5.3) |
Infiltrate/atelectasis | <0.001 | 5.0 (3.2 to 7.6) |
PICU admission | 0.015 | 2.5 (1.2 to 5.3) |
Serum C reactive protein (mg/L) * | <0.001 |
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García-García, M.L.; Alcolea, S.; Alonso-López, P.; Martín-Martín, C.; Tena-García, G.; Casas, I.; Pozo, F.; Méndez-Echevarría, A.; Hurtado-Gallego, J.; Calvo, C. Antibiotic Utilization in Hospitalized Children with Bronchiolitis: A Prospective Study Investigating Clinical and Epidemiological Characteristics at a Secondary Hospital in Madrid (2004–2022). Pathogens 2023, 12, 1397. https://doi.org/10.3390/pathogens12121397
García-García ML, Alcolea S, Alonso-López P, Martín-Martín C, Tena-García G, Casas I, Pozo F, Méndez-Echevarría A, Hurtado-Gallego J, Calvo C. Antibiotic Utilization in Hospitalized Children with Bronchiolitis: A Prospective Study Investigating Clinical and Epidemiological Characteristics at a Secondary Hospital in Madrid (2004–2022). Pathogens. 2023; 12(12):1397. https://doi.org/10.3390/pathogens12121397
Chicago/Turabian StyleGarcía-García, María Luz, Sonia Alcolea, Patricia Alonso-López, Clara Martín-Martín, Guadalupe Tena-García, Inmaculada Casas, Francisco Pozo, Ana Méndez-Echevarría, Jara Hurtado-Gallego, and Cristina Calvo. 2023. "Antibiotic Utilization in Hospitalized Children with Bronchiolitis: A Prospective Study Investigating Clinical and Epidemiological Characteristics at a Secondary Hospital in Madrid (2004–2022)" Pathogens 12, no. 12: 1397. https://doi.org/10.3390/pathogens12121397