Especially These Days, Kids Hospitalized with CAP May Be Coming Your Way Post Discharge

COVID-19 continues to have many people a little skittish about rushing to the emergency room. And between the pandemic and staffing problems, even some hospital administrators are recommending that patients visit an urgent care center unless they truly have an emergency. As such, urgent care providers should be aware of a new study published by JAMA Network regarding the need for re-treatment of children who were hospitalized with community-acquired pneumonia. The population consisted of 824 children 6 months of age and older who were treated with amoxicillin for CAP at 28 hospitals in the United Kingdom and Ireland between February 2017 and April 2019. They were randomized 1:1 to receive oral amoxicillin at a lower dose (35-50 mg/kg/d; n=410) or higher dose (70-90 mg/kg/d; n=404), for a shorter duration (3 days; n=413) or a longer duration (7 days; n = 401). Both groups demonstrated noninferiority with the lower dose and shorter length of treatment. In fact, outcomes were nearly identical; 12.6% of children who got the lower dose needed retreatment at 28 days compared with 12.4% of those who received the higher dose. Similarly, 12.5% of the “short duration” group needed retreatment, as did 12.5% of the longer-duration subjects. With antibiotic stewardship always being a priority, regardless of the state of the COVID-19 pandemic, data indicating that a lower dose of any drug for a shorter period of time is therapeutically adequate are something to bear in mind.