Managing Bacterial Pneumonia in Children Without Antimicrobials

Can Community-acquired Bacterial Pneumonia in Children be Safely Managed Without Antibiotics in an Integrative Medicine Context? A Retrospective Cohort Analysis

Retrospective cohort analysis of children hospitalized for pneumonia comparing disease severity on admission, clinical course, treatment and outcomes and prospective telephone based Follow-Up assessement.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

The investigators will conduct a retrospective cohort analysis of children hospitalized for pneumonia at the Filderklinik between December 2006 and November 2010. The Bacterial Pneumonia Score, a validated composite laboratory, clinical and radiologic score developed by Moreno et al, will be retrospectively applied to define cases as either viral or bacterial pneumonia. The investigators will compare disease severity on admission, clinical course, and outcomes (in terms of complications, length of stay and readmission rates) between antimicrobial and non-antimicrobial managed bacterial pneumonia cases. Long-term Follow-Up will be assessed by telephone interviews with the parents.

Study Type

Observational

Enrollment (Actual)

350

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Baden-Württemberg
      • Filderstadt, Baden-Württemberg, Germany, 70794
        • Arcim Institute

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

No older than 18 years (Child, Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Sampling Method

Probability Sample

Study Population

Children from infancy till adolecence admitted to hospital (Filderklinik, Germany) for pneumonia treatment

Description

Inclusion Criteria:

  • Hospital admission at the pediatric department of the Filderklinik.
  • Admission diagnosis pneumonia (ICD J12.0, J12.1, J12.8, J12.9, J14, J15.1, J15.6, J15.7, J15.8, J15.9, J16.8, J18.0, J18.1, J18.8, J18.9 - all 12s, 15s, 16s, 18s)

Exclusion Criteria:

  • None

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Cure rate of non-antimicrobial management of bacterial pneumonia
Time Frame: Between admission and 3 months after discharge
Cure rate of non-antimicrobial management of bacterial pneumonia (in the following and in the final publication, the term "bacterial pneumonia" will be used for children who fulfill the Moreno criteria for pneumonia): % of children managed without antimicrobials since admission, without subsequent need for antimicrobials or readmission.
Between admission and 3 months after discharge
Medical complication rate
Time Frame: Between admission and 3 months after discharge
Medical complication rate among children with bacterial pneumonia, treated with or without antimicrobials
Between admission and 3 months after discharge
Length of hospital stay
Time Frame: Between admission and 3 months after discharge
Length of hospital stay for children with bacterial pneumonia, managed with or without antimicrobials
Between admission and 3 months after discharge
Readmission rate
Time Frame: 7 - 10 years after hospitalization
Readmission rate for pneumonia among children with bacterial pneumonia, managed with or without antimicrobials
7 - 10 years after hospitalization
Temperature normalization
Time Frame: Between admission and 3 months after discharge
Days to temperature normalization (< 38°C) in children with bacterial pneumonia, managed with or without antimicrobials
Between admission and 3 months after discharge
Days of supplemental oxygen need
Time Frame: Between admission and 3 months after discharge
Days of supplemental oxygen need in children with bacterial pneumonia, managed with or without antimicrobials
Between admission and 3 months after discharge

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Changes in respiratory rate
Time Frame: Between admission and 3 months after discharge
Changes in respiratory rate as an indicator for pulmonary infection
Between admission and 3 months after discharge
Changes in Bacterial Pneumonia Score
Time Frame: Between admission and 3 months after discharge
Changes in Bacterial Pneumonia Score as an indicator for pulmonary infection
Between admission and 3 months after discharge
Changes in oxygen saturation
Time Frame: Between admission and 3 months after discharge
Changes in oxygen saturation as an indicator for pulmonary infection
Between admission and 3 months after discharge
Changes in CRP
Time Frame: Between admission and 3 months after discharge
Changes in CRP as an indicator for infection
Between admission and 3 months after discharge
Changes in leukocyte count
Time Frame: Between admission and 3 months after discharge
Changes in leukocyte count as an indicator for infection
Between admission and 3 months after discharge
Changes in pH
Time Frame: Between admission and 3 months after discharge
Changes in pH as an indicator for respiratory distress
Between admission and 3 months after discharge
Changes in pCO2
Time Frame: Between admission and 3 months after discharge
Changes in pCO2 as an indicator for respiratory distress
Between admission and 3 months after discharge
Rate of chronic and acute-infectious co-morbidities
Time Frame: Day of admission
Rate of chronic and acute-infectious co-morbidities on admission in children with bacterial pneumonia, subsequently managed with or without antimicrobials
Day of admission
Utilization rate of a package of complementary treatment measures
Time Frame: Between admission and 3 months after discharge
Utilization rate of a package of complementary treatment measures from anthroposophic medicine (including oral medications, inhalation and external nursing applications) in children managed with or without antimicrobials
Between admission and 3 months after discharge
Antimicrobial treatment rate in children with viral pneumonia
Time Frame: Between admission and 3 months after discharge
Antimicrobial treatment rate in children classified as viral pneumonia by Bacterial Pneumonia Score
Between admission and 3 months after discharge
Number of patients treated with antipyretics
Time Frame: Between admission and 3 months after discharge
Number of patients treated with antipyretics
Between admission and 3 months after discharge

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

October 15, 2017

Primary Completion (Actual)

November 30, 2017

Study Completion (Actual)

February 25, 2018

Study Registration Dates

First Submitted

July 6, 2017

First Submitted That Met QC Criteria

August 17, 2017

First Posted (Actual)

August 22, 2017

Study Record Updates

Last Update Posted (Actual)

February 17, 2020

Last Update Submitted That Met QC Criteria

February 13, 2020

Last Verified

February 1, 2020

More Information

Terms related to this study

Other Study ID Numbers

  • PKA_01

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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