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Journal of Antimicrobial Chemotherapy (1999) 44, 709-715
© 1999 The British Society for Antimicrobial Chemotherapy

Antimicrobial practice

Sequential antimicrobial therapy: treatment of severe lower respiratory tract infections in children

Fahad A. Al-Eidana, James C. McElnaya,*, M. G. Scottb, M. P. Kearneyc, K. E. U. Troughtond and J. Jenkinsd

a Pharmacy Practice Research Group, School of Pharmacy, The Queen's University of Belfast, 97 Lisburn Road, Belfast BT9 7BL; b Antrim Hospital Academic Pharmacy Practice Unit, Antrim Area Hospital, Bush Road, Antrim BT41 2RL; c Department of Microbiology, United Hospital Group Trust, Bush Road, Antrim BT41 2RL d Paediatric Department, United Hospital Group Trust, Bush Road, Antrim BT41 2RL, N. Ireland

Abstract

Although there have been a number of studies in adults, to date there has been little research into sequential antimicrobial therapy (SAT) in paediatric populations. The present study evaluates the impact of a SAT protocol for the treatment of severe lower respiratory tract infection in paediatric patients. The study involved 89 paediatric patients (44 control and 45 SAT). The SAT patients had a shorter length of hospital stay (4.0 versus 8.3 days), shorter duration of inpatient antimicrobial therapy (4.0 versus 7.9 days) with the period of iv therapy being reduced from a mean of 5.6 to 1.7 days. The total healthcare costs were reduced by 52%. The resolution of severe lower respiratory tract infection with a short course of iv antimicrobials, followed by conversion to oral therapy yielded clinical outcomes comparable to those achieved using longer term iv therapy. SAT proved to be an important cost-minimizing tool for realizing substantial healthcare costs savings.

Notes

* Corresponding author. Tel:+44-1232-335-800; Fax:+44-1232-247-947.


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