Parent and Clinician Views on Not Using Antibiotics for Mild Community-Acquired Pneumonia.
Pediatrics
; 153(2)2024 Jan 01.
Article
in En
| MEDLINE
| ID: mdl-38234215
ABSTRACT
OBJECTIVES:
Preschool-aged children with mild community-acquired pneumonia (CAP) routinely receive antibiotics even though most infections are viral. We sought to identify barriers to the implementation of a "no antibiotic" strategy for mild CAP in young children.METHODS:
Qualitative study using semistructured interviews conducted in a large pediatric hospital in the United States from January 2021 to July 2021. Parents of young children diagnosed with mild CAP in the previous 3 years and clinicians practicing in outpatient settings (pediatric emergency department, community emergency department, general pediatrics offices) were included.RESULTS:
Interviews were conducted with 38 respondents (18 parents, 20 clinicians). No parent heard of the no antibiotic strategy, and parents varied in their support for the approach. Degree of support related to their desire to avoid unnecessary medications, trust in clinicians, the emotional difficulty of caring for a sick child, desire for relief of suffering, willingness to accept the risk of unnecessary antibiotics, and judgment about the child's illness severity. Eleven (55%) clinicians were familiar with guidelines specifying a no antibiotic strategy. They identified challenges in not using antibiotics, including diagnostic uncertainty, consequences of undertreatment, parental expectations, follow-up concerns, and acceptance of the risks of unnecessary antibiotic treatment of many children if it means avoiding adverse outcomes for some children.CONCLUSIONS:
Although both parents and clinicians expressed broad support for the judicious use of antibiotics, pneumonia presents stewardship challenges. Interventions will need to consider the emotional, social, and logistical aspects of managing pneumonia, in addition to developing techniques to improve diagnosis.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pneumonia
/
Community-Acquired Infections
Type of study:
Diagnostic_studies
/
Guideline
/
Prognostic_studies
/
Qualitative_research
Limits:
Child
/
Child, preschool
/
Humans
Country/Region as subject:
America do norte
Language:
En
Journal:
Pediatrics
Year:
2024
Document type:
Article
Country of publication:
Estados Unidos