The risks of postoperative complications and prolonged hospital stay in children receiving bronchoscopy.

BACKGROUND: Foreign body aspiration (FBA) is a common problem among children that needs to be recognized and managed quickly. Our study aimed at comparing risk factors associated with adverse events in children receiving either flexible or rigid bronchoscopy, by reporting and analyzing our experience in the removal of airway FB primarily through flexible bronchoscopy. METHODS: A total of 3489 FBA patients were retrospectively examined. The clinical events, bronchoscopy findings, radiological findings and procedural complications were reported and analyzed. RESULTS: According to Fisher's exact test, preoperative cardiovascular instability, pre-operative pulmonary disease or need of lung assistance, operative time greater than 30 min, and history of ineffective rigid bronchoscopy were associated with postoperative adverse events. These same factors were also associated with prolonged hospital stay (more than 2 days). Using multivariate analysis, preoperative pulmonary disease or need of lung assistance and history of ineffective rigid bronchoscopy were associated with postoperative adverse events. These same factors were significantly associated with prolonged hospital stay. CONCLUSIONS: Our study demonstrated that using flexible bronchoscopy to extract foreign bodies in children generally exhibits a low adverse events incidence. The risk of postoperative complications and prolonged hospital stay may significantly be higher for children with pre-operative pulmonary disease, prolonged operative time, and history of ineffective rigid bronchoscopy. Type of study Treatment Study. Level of evidence Level III.

Evaluation of 3-day azithromycin or 5-day cefaclor in comparison with 10-day amoxicillin for treatment of tonsillitis in children.

To evaluate the clinical efficacy of azithromycin, cefaclor, and amoxicillin in treatment of pediatric tonsillitis, a total of 256 children with Group A ß-hemolytic streptococcus (GAS) tonsillitis were randomly divided into 3 groups. Only patients assessed with streptococcus-positive tonsillitis, considered to be compliant with treatment and complete clinical and microbiological evaluations at the end of therapy (day 14) and follow-up (day 30) were included in the efficacy analysis. Our study demonstrated that 96.4% of patients in the azithromycin group, 92.4% of patients in the cefaclor group, and 91.0% of patients in the amoxicillin group were recorded as clinical success at the end of therapy. Bacteriological eradication rates of the 3 groups at the end of therapy were 94.0%, 89.9%, and 88.5%, respectively. A pathogen recurrence rate was evaluated as 2.6%, 7.0%, and 5.9% at the follow-up. Treatment-stimulated adverse events occurred in 2.4% of patients in the azithromycin group, 11.3% in the cefaclor group, and 11.4% in the amoxicillin group. In summary, azithromycin showed an effective tendency for the treatment of pediatric tonsillitis with lower occurrence rate of adverse reactions, although there is no statistical significance for the clinical and bacteriological eradication efficacy between these 3 groups.