{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T13:25:02Z","timestamp":1791379502355,"version":"4.3.2"},"reference-count":42,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2019,11,20]],"date-time":"2019-11-20T00:00:00Z","timestamp":1574208000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["K08HS025138"],"award-info":[{"award-number":["K08HS025138"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["K01AI125413"],"award-info":[{"award-number":["K01AI125413"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["shmpublications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Hospital Medicine"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>To compare hospital outcomes associated with commonly used antibiotic therapies for aspiration pneumonia in children with neurologic impairment (NI).<\/jats:p><\/jats:sec><jats:sec><jats:title>DESIGN\/METHODS<\/jats:title><jats:p>A retrospective study of children with NI hospitalized with aspiration pneumonia at 39 children's hospitals in the Pediatric Health Information System database. Exposure was empiric antibiotic therapy classified by antimicrobial activity. Outcomes included acute respiratory failure, intensive care unit (ICU) transfer, and hospital length of stay (LOS). Multivariable regression evaluated associations between exposure and outcomes and adjusted for confounders, including medical complexity and acute illness severity.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>In the adjusted analysis, children receiving Gram\u2010negative coverage alone had two\u2010fold greater odds of respiratory failure (odds ratio [OR] 2.15; 95% CI: 1.41\u20103.27), greater odds of ICU transfer (OR 1.80; 95% CI: 1.03\u20103.14), and longer LOS [adjusted rate ratio (RR) 1.28; 95% CI: 1.16\u20101.41] than those receiving anaerobic coverage alone. Children receiving anaerobic and Gram\u2010negative coverage had higher odds of respiratory failure (OR 1.65; 95% CI: 1.19\u20102.28) than those receiving anaerobic coverage alone, but ICU transfer (OR 1.15; 95% CI: 0.73\u20101.80) and length of stay (RR 1.07; 95% CI: 0.98\u20101.16) did not statistically differ. For children receiving anaerobic, Gram\u2010negative, and <jats:italic>P. aeruginosa<\/jats:italic> coverage, LOS was shorter (RR 0.83; 95% CI: 0.76\u20100.90) than those receiving anaerobic coverage alone; odds of respiratory failure and ICU transfer rates did not significantly differ.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Anaerobic therapy appears to be important in the treatment of aspiration pneumonia in children with NI. 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