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Commentary on: Shah SS, Srivastava R, Wu S, et al. Intravenous versus oral antibiotics for postdischarge treatment of complicated pneumonia. Pediatrics 2016;138:e20161692.
In children, complicated pneumonia implies pneumonia infection that is associated with pleural effusion or empyema.1 Initial management involves use of parenteral broad spectrum antibiotics to cover the most common organisms1; thoracotomy or chest tube insertion may be indicated if there is no response to antibiotic therapy, or if there is significant respiratory difficulty. Most national guidelines do not specify the preferred route of antibiotic therapy for postdischarge treatment. For instance, British guidelines recommend a switch to oral antibiotics if there is clear evidence of improvement,2 while American guidelines are non-specific.3 This retrospective study compared the benefits and harms of intravenous versus oral antibiotic therapy for treatment of complicated pneumonia in children postdischarge.
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Competing interests None declared.
Provenance and peer review Commissioned; internally peer reviewed.