{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T13:26:07Z","timestamp":1791379567336,"version":"4.3.3"},"reference-count":21,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,1,1]]},"abstract":"BACKGROUND AND OBJECTIVE:<\/jats:title>Narrow-spectrum antibiotics are recommended as the first-line agent for children hospitalized with community-acquired pneumonia (CAP). There is little scientific evidence to support that this consensus-based recommendation is as effective as the more commonly used broad-spectrum antibiotics. The objective was to compare the effectiveness of empiric treatment with narrow-spectrum therapy versus broad-spectrum therapy for children hospitalized with uncomplicated CAP.<\/jats:p><\/jats:sec>METHODS:<\/jats:title>This multicenter retrospective cohort study using medical records included children aged 2 months to 18 years at 4 children's hospitals in 2010 with a discharge diagnosis of CAP. Patients receiving either narrow-spectrum or broad-spectrum therapy in the first 2 days of hospitalization were eligible. Patients were matched by using propensity scores that determined each patient\u2019s likelihood of receiving empiric narrow or broad coverage. A multivariate logistic regression analysis evaluated the relationship between antibiotic and hospital length of stay (LOS), 7-day readmission, standardized daily costs, duration of fever, and duration of supplemental oxygen.<\/jats:p><\/jats:sec>RESULTS:<\/jats:title>Among 492 patients, 52% were empirically treated with a narrow-spectrum agent and 48% with a broad-spectrum agent. In the adjusted analysis, the narrow-spectrum group had a 10-hour shorter LOS (P = .04). There was no significant difference in duration of oxygen, duration of fever, or readmission. When modeled for LOS, there was no difference in average daily standardized cost (P = .62) or average daily standardized pharmacy cost (P = .26).<\/jats:p><\/jats:sec>CONCLUSIONS:<\/jats:title>Compared with broad-spectrum agents, narrow-spectrum antibiotic coverage is associated with similar outcomes. Our findings support national consensus recommendations for the use of narrow-spectrum antibiotics in children hospitalized with CAP.<\/jats:p><\/jats:sec>","DOI":"10.1542\/peds.2013-1773","type":"journal-article","created":{"date-parts":[[2013,12,10]],"date-time":"2013-12-10T01:55:42Z","timestamp":1386640542000},"page":"e23-e29","source":"Crossref","is-referenced-by-count":49,"title":["Comparative Effectiveness of Empiric Antibiotics for Community-Acquired Pneumonia"],"prefix":"10.1542","volume":"133","author":[{"given":"Mary Ann","family":"Queen","sequence":"first","affiliation":[{"name":"Divisions of Hospital Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela L.","family":"Myers","sequence":"additional","affiliation":[{"name":"Infectious Disease, Children\u2019s Mercy Hospitals and Clinics and the University of Missouri School of Medicine, Kansas City, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Hall","sequence":"additional","affiliation":[{"name":"The Children\u2019s Hospital Association, Overland Park, Kansas;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samir S.","family":"Shah","sequence":"additional","affiliation":[{"name":"Divisions of Infectious Diseases and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek J.","family":"Williams","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine, The Monroe Carell Jr Children\u2019s Hospital at Vanderbilt, Vanderbilt University School of Medicine, Nashville, Tennessee; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine A.","family":"Auger","sequence":"additional","affiliation":[{"name":"Hospital Medicine, Cincinnati Children\u2019s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen E.","family":"Jerardi","sequence":"additional","affiliation":[{"name":"Hospital Medicine, Cincinnati Children\u2019s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela M.","family":"Statile","sequence":"additional","affiliation":[{"name":"Hospital Medicine, Cincinnati Children\u2019s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel S.","family":"Tieder","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, 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