The influence of chest X-ray results on antibiotic prescription for childhood pneumonia in the emergency department
Rattachement africain : nl. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
The aim of this study is to evaluate the influence of chest X-ray (CXR) results on antibiotic prescription in children suspected of lower respiratory tract infections (RTI) in the emergency department (ED). We performed a secondary analysis of a stepped-wedge, cluster randomized trial of children aged 1 month to 5 years with fever and cough/dyspnoea in 8 EDs in the Netherlands (2016-2018), including a 1-week follow-up. We analysed the observational data of the pre-intervention period, using multivariable logistic regression to evaluate the influence of CXR result on antibiotic prescription. We included 597 children (median age 17 months [IQR 9-30, 61% male). CXR was performed in 109/597 (18%) of children (range across hospitals 9 to 50%); 52/109 (48%) showed focal infiltrates. Children who underwent CXR were more likely to receive antibiotics, also when adjusted for clinical signs and symptoms, hospital and CXR result (OR 7.25 [95% CI 2.48-21.2]). Abnormalities on CXR were not significantly associated with antibiotic prescription.Conclusion: Performance of CXR was independently associated with more antibiotic prescription, regardless of its results. The limited influence of CXR results on antibiotic prescription highlights the inferior role of CXR on treatment decisions for suspected lower RTI in the ED. What is Known: • Chest X-ray (CXR) has a high inter-observer variability and cannot distinguish between bacterial or viral pneumonia. • Current guidelines recommend against routine use of CXR in children with uncomplicated respiratory tract infections (RTIs) in the outpatient setting. What is New: • CXR is still frequently performed in non-complex children suspected of lower RTIs in the emergency department • CXR performance was independently associated with more antibiotic prescriptions, regardless of its results, highlighting the inferior role of chest X-rays in treatment decisions.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- The influence of chest X-ray results on antibiotic prescription for childhood pneumonia in the emergency department
- Date Crossref
- 22/03/2021
- Éditeur
- Springer Science and Business Media LLC
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Erasmus MC - Sophia Children’s Hospital Department of General Paediatrics pays non établi dans la noticeÉtablissement de santé
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Flevoziekenhuis pays non établi dans la noticeÉtablissement de santé
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Maasstad Ziekenhuis pays non établi dans la noticeÉtablissement de santé
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Reinier de Graaf Hospital pays non établi dans la noticeÉtablissement de santé
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Sint Franciscus Gasthuis pays non établi dans la noticeÉtablissement de santé
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Elisabeth-TweeSteden Ziekenhuis pays non établi dans la noticeÉtablissement de santé
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Lange Land Ziekenhuis pays non établi dans la noticeÉtablissement de santé
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Erasmus MC – Sophia Children's Hospital Department of General Paediatrics pays non établi dans la noticeÉtablissement de santé
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HAGA-Juliana Children's Hospital Department of Paediatrics pays non établi dans la noticeÉtablissement de santé
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Department of Paediatrics pays non établi dans la noticeInstitution
Department of General Paediatrics — Erasmus MC - Sophia Children’s Hospital, Flevoziekenhuis et Maasstad Ziekenhuis, avec 7 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.