Choosing Wisely:

Don’t use broad-spectrum antibiotics such as ceftriaxone for children hospitalized with uncomplicated CAP. Use narrow-spectrum antibiotics such as penicillin, ampicillin, or amoxicillin.

Rationale and Comments: Using broad-spectrum antibiotic therapy does not improve rates of treatment failure, improve length of stay, or decrease costs when compared with narrow-spectrum antibiotic therapy for children hospitalized with CAP. The use of narrow-spectrum antibiotics for children hospitalized with CAP can limit the development of multidrug-resistant organisms, while achieving similar or better outcomes.
Sponsoring Organizations:
  • Pediatric Hospital Medicine – SHM, AAP, APA
  • Sources:
  • Retrospective cohort study
  • Disciplines:
  • Pulmonary medicine
  • Infectious disease
  • Pediatric
  • References: • Bradley JS, et al.; Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. The management of community-acquired pneumonia in infants and children older than 3 months of age: clinical practice guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. Clin Infect Dis. 2011;53(7):e25-76.
    • Williams DJ, et al. Narrow vs broad-spectrum antimicrobial therapy for children hospitalized with pneumonia. Pediatrics. 2013;132(5):e1141-1148.
    • Queen MA, et al. Comparative effectiveness of empiric antibiotics for community-acquired pneumonia. Pediatrics. 2014;133(1):e23-29.
    • Thomson J, et al. Hospital outcomes associated with guideline-recommended antibiotic therapy for pediatric pneumonia. J Hosp Med. 2015;10(1):13-18.

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