{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T12:57:26Z","timestamp":1779195446101,"version":"3.51.4"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T00:00:00Z","timestamp":1673308800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R34HL153474"],"award-info":[{"award-number":["R34HL153474"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,27]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The absence of consensus for outcomes in pediatric antibiotic trials is a major barrier to research harmonization and clinical translation. We sought to develop expert consensus on study outcomes for clinical trials of children with mild community-acquired pneumonia (CAP).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Applying the Delphi method, a multispecialty expert panel ranked the importance of various components of clinical response and treatment failure outcomes in children with mild CAP for use in research. During Round 1, panelists suggested additional outcomes in open-ended responses that were added to subsequent rounds of consensus building. For Rounds 2 and 3, panelists were provided their own prior responses and summary statistics for each item in the previous round. The consensus was defined by &amp;gt;70% agreement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The expert panel determined that response to and failure of treatment should be addressed at a median of 3 days after initiation. Complete or substantial improvement in fever, work of breathing, dyspnea, tachypnea when afebrile, oral intake, and activity should be included as components of adequate clinical response outcomes. Clinical signs and symptoms including persistent or worsening fever, work of breathing, and reduced oral intake should be included in treatment failure outcomes. Interventions including receipt of parenteral fluids, supplemental oxygen, need for high-flow nasal cannula oxygen therapy, and change in prescription of antibiotics should also be considered in treatment failure outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Clinical response and treatment failure outcomes determined by the consensus of this multidisciplinary expert panel can be used for pediatric CAP studies to provide objective data translatable to clinical practice.<\/jats:p><\/jats:sec>","DOI":"10.1093\/jpids\/piac123","type":"journal-article","created":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T16:02:50Z","timestamp":1673366570000},"page":"83-88","source":"Crossref","is-referenced-by-count":3,"title":["Developing Consensus on Clinical Outcomes for Children with Mild Pneumonia: A Delphi Study"],"prefix":"10.1093","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4387-2605","authenticated-orcid":false,"given":"Todd A","family":"Florin","sequence":"first","affiliation":[{"name":"Division of Emergency Medicine, Ann and Robert H. Lurie Children\u2019s Hospital of Chicago & Northwestern University Feinberg School of Medicine , Chicago, Illinois , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joy","family":"Melnikow","sequence":"additional","affiliation":[{"name":"Center for Healthcare Policy and Research, University of California Davis School of Medicine , Sacramento, California , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa","family":"Gosdin","sequence":"additional","affiliation":[{"name":"Center for Healthcare Policy and Research, University of California Davis School of Medicine , Sacramento, California , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan","family":"Ciuffetelli","sequence":"additional","affiliation":[{"name":"Center for Healthcare Policy and Research, University of California Davis School of Medicine , Sacramento, California , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jillian","family":"Benedetti","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, Ann and Robert H. Lurie Children\u2019s Hospital of Chicago & Northwestern University Feinberg School of Medicine , Chicago, Illinois , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dustin","family":"Ballard","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine and Division of Research, Kaiser Permanente Northern California; Department of Emergency Medicine, University of California Davis School of Medicine , Sacramento, California , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianne","family":"Gausche-Hill","sequence":"additional","affiliation":[{"name":"Los Angeles County Emergency Medical Services Agency; Harbor-UCLA Medical Center; The David Geffen School of Medicine at UCLA , Los Angeles, California , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1856-6841","authenticated-orcid":false,"given":"Matthew P","family":"Kronman","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Infectious Diseases, University of Washington , Seattle, Washington , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa A","family":"Martin","sequence":"additional","affiliation":[{"name":"Pediatric Health Associates , Naperville, Illinois , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rakesh D","family":"Mistry","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Section of Emergency Medicine, University of Colorado School of Medicine , Aurora, Colorado , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark I","family":"Neuman","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, Boston Children\u2019s Hospital , Boston, Massachusetts , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Debra L","family":"Palazzi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Infectious Diseases, Baylor College of Medicine, Texas Children\u2019s Hospital , Houston, Texas , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sameer J","family":"Patel","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Ann & Robert H. Lurie Children\u2019s Hospital of Chicago, Northwestern University Feinberg School of Medicine , Chicago, Illinois , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wesley H","family":"Self","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine and Vanderbilt Institute for Clinical and Translational Sciences, Vanderbilt University Medical Center , Nashville, Tennessee , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samir S","family":"Shah","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine, Cincinnati Children\u2019s Hospital Medical Center; Department of Pediatrics, University of Cincinnati College of Medicine , Cincinnati, Ohio , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonal N","family":"Shah","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, Boston Children\u2019s Hospital, Harvard Medical School , Boston, Massachusetts , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Sirota","sequence":"additional","affiliation":[{"name":"Division of Community Based General Pediatrics, Ann & Robert H. 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