{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T14:01:52Z","timestamp":1784728912705,"version":"3.55.0"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T00:00:00Z","timestamp":1778889600000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["1R01HS027619"],"award-info":[{"award-number":["1R01HS027619"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Test the association between early antibiotic discontinuation and outcomes for children with a tracheostomy and positive respiratory viral PCR (RVP) hospitalized with suspected bTRAIN (bacterial TRacheostomy\u2010Associated INfection; pneumonia\/tracheitis).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a multicenter cohort study between September 1, 2021 and August 31, 2024 of children with pre\u2010existing tracheostomy hospitalized for suspected bTRAIN (tracheal aspirate bacterial culture sent and bTRAIN antibiotics started) at six children's hospitals with: (1) a positive RVP test; (2) no antibiotic pre\u2010treatment; and (3) length of stay (LOS)\u2009&lt;\u200937 days (outlier). Mixed\u2010effects regression models identified independent associations between early antibiotic discontinuation and our primary outcome, LOS (in days). Inverse probability treatment weighting based on propensity scoring adjusted for measured confounding. We explored the association between early antibiotic discontinuation and 3 secondary outcomes: late ICU transfer, in\u2010hospital mortality, and 30\u2010day bTRAIN rehospitalization rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 542 hospitalizations in 365 children, the median admission age was 4 years (interquartile range [IQR]: 2\u20138 years). Common viruses included rhinovirus (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009282; 52%), SARS\u2010CoV\u20102 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200963; 12%), and respiratory syncytial virus (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200961; 11%). The median LOS was 7 days (IQR: 5\u201311 days). Only 28% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009152) had early antibiotic discontinuation; full bTRAIN treatment was associated with a 23% (5%\u201345%) increased LOS, with estimated LOS means (95% CI) of 7.0 (5.8\u20138.4) days for early antibiotic discontinuation and 8.6 (7.8\u20139.4) days in the bTRAIN\u2010treated group. Secondary outcome rates (late ICU transfer\u2009=\u200914.6%; in\u2010hospital mortality\u2009=\u20090.9%; 30\u2010day bTRAIN rehospitalization rate\u2009=\u20098.3%) were similar rates between both groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Given similar rates of serious outcomes in both groups, clinicians could consider early discontinuation of antibiotic treatment in children with suspected bTRAINs who have a positive RVP test.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71652","type":"journal-article","created":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T13:26:17Z","timestamp":1778937977000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Early Antibiotic Discontinuation for Children With a Positive Rapid Respiratory Viral Test Hospitalized for Suspected Bacterial Tracheostomy\u2010Associated Infections"],"prefix":"10.1002","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5269-7861","authenticated-orcid":false,"given":"Christopher J.","family":"Russell","sequence":"first","affiliation":[{"name":"Division of Pediatric Hospital Medicine, Department of Pediatrics Stanford University Palo Alto California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoko","family":"Kono","sequence":"additional","affiliation":[{"name":"Department of Population and Public Health Sciences, Keck School of Medicine University of Southern California Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Rush","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine Children's National Hospital Washington DC USA"},{"name":"Department of Pediatrics George Washington University School of Medicine and Health Sciences Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Hahn","sequence":"additional","affiliation":[{"name":"Department of Pediatrics George Washington University School of Medicine and Health Sciences Washington DC USA"},{"name":"Division of Infectious Diseases Children's National Hospital Washington DC USA"},{"name":"Center for Precision Medicine and Genomic Research Children's National Research Institute Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine S.","family":"Forster","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Pittsburgh Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan D.","family":"Cogen","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Sleep Medicine, Department of Pediatrics, Seattle Children's Hospital University of Washington Seattle Washington USA"},{"name":"Department of Pediatrics, Seattle Children's Hospital University of Washington Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah Hofman","family":"DeYoung","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Sleep Medicine, Department of Pediatrics, Seattle Children's Hospital University of Washington Seattle Washington USA"},{"name":"Department of Pediatrics, Seattle Children's Hospital University of Washington Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2882-8849","authenticated-orcid":false,"given":"John M.","family":"Morrison","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hospital Medicine Johns Hopkins All Children's Hospital St. Petersburg Florida USA"},{"name":"Department of Pediatrics Johns Hopkins University School of Medicine Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7538-0998","authenticated-orcid":false,"given":"Joanna","family":"Thomson","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine and James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center and Department of Pediatrics University of Cincinnati College of Medicine Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sukhada Vaidya","family":"Mairal","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hospital Medicine, Department of Pediatrics Stanford University Palo Alto California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy J.","family":"Mack","sequence":"additional","affiliation":[{"name":"Department of Population and Public Health Sciences, Keck School of Medicine University of Southern California Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael N.","family":"Neely","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Children's Hospital Los Angeles Los Angeles California USA"},{"name":"Department of Pediatrics, Keck School of Medicine University of Southern California Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamara D.","family":"Simon","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Keck School of Medicine University of Southern California Los Angeles California USA"},{"name":"Division of Hospital Medicine Children's Hospital Los Angeles Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the Pediatric Research in Inpatient Settings Network","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,16]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.27117"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1542\/hpeds.2016-0104"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/hpeds.2017-0106"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24797"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02232-20"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.00930-22"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000000106"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000001001"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-1634"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1359-6101(03)00059-5"},{"issue":"1","key":"e_1_2_11_12_1","first-page":"1009","article-title":"The Acute Respiratory Distress Syndrome: Mechanisms and Perspective Therapeutic Approaches","volume":"2","author":"Gonzales J. 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