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Combination therapy offered little benefit for children hospitalized with CAP
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SAN DIEGO — The addition of azithromycin to therapy for children hospitalized with community-acquired pneumonia was not associated with increased length of stay, according to study results presented here at ID Week.
The potential benefit of macrolide combination therapy for moderate to severe pediatric community-acquired pneumonia (CAP) in children is unclear, according to background information in the study.
To address this, researchers compared the effectiveness of ceftriaxone to ceftriaxone plus azithromycin among children enrolled in the CDC Etiology of Pneumonia in the Community (EPIC) study and hospitalized with clinical and radiographic evidence of CAP at three hospitals in Tennessee and Utah.
Derek J. Williams, MD, MPH, assistant professor of pediatrics at the Vanderbilt University School of Medicine, and colleagues restricted analysis to children receiving initial therapy with ceftriaxone alone or ceftriaxone plus azithromycin during the first 2 days of hospitalization.
Hospital length of stay served as the primary outcome.
Of the 678 children included in the analysis, 522 (77%) patients with a median age of 18 months received ceftriaxone alone and 156 (23%) patients with a median age of 57 months received ceftriaxone plus azithromycin.
Median length of stay was similar between groups — ceftriaxone alone (62 hours) vs. ceftriaxone plus azithromycin (58 hours; adjusted HR=0.86; 95% CI, 0.70-1.05), according to results from the study.
Propensity score matching retained 132 children in each exposure group. Results from this analysis were similar (adjusted HR=0.94; 95% CI, 0.74-1.20).
“Our results were consistent in both multivariable and propensity matched analyses, suggesting little benefit in empiric combination therapy for children hospitalized with CAP,” Williams said.
For more information:
Williams DJ. Abstract #82. Presented at: ID Week. Oct. 17-21, 2012; San Diego.
Disclosure: Williams and colleagues report no relevant financial disclosures.