Risk Factors for Antibiotic-Associated Diarrhoea in Paediatric Patients With Severe Pneumonia: A Retrospective Cohort.

BACKGROUND

Severe pneumonia in paediatric patients typically necessitates prolonged courses of antibiotic therapy, a practice that elevates vulnerability to antibiotic-associated diarrhoea (AAD).

AIM: The present study aimed to evaluate the clinical profiles of paediatric patients with AAD secondary to severe pneumonia and to explore evidence-based nursing interventions for this complication.

STUDY

DESIGN

A retrospective cohort. This study was conducted at a tertiary hospital in China, enrolling paediatric patients diagnosed with severe pneumonia. To identify independent risk factors for AAD development, a stepwise analytical framework was applied, comprising univariate analysis, correlation analysis and multivariate logistic regression modelling.

RESULTS

A total of 306 children with severe pneumonia were included. The overall incidence of secondary AAD among this cohort was 13.73% (42/306). The median time from antibiotic initiation to AAD onset was 5 days (IQR 3-8 days). Multivariate logistic regression analysis identified five independent risk factors for AAD: age < 1 year (odds ratio [OR] = 2.246, 95% confidence interval [CI]: 1.821-2.909), administration of penicillin-class antibiotics (OR = 2.474, 95% CI: 2.043-3.061), antibiotic treatment duration ≥ 1 week (OR = 2.970, 95% CI: 2.127-3.507), requirement for mechanical ventilation (OR = 3.049, 95% CI: 2.895-3.725), and hospital stay > 14 days (OR = 1.954, 95% CI: 1.630-2.402). In contrast, prophylactic probiotic administration was identified as a protective factor against AAD (OR = 0.801, 95% CI: 0.586-0.944).

CONCLUSIONS

In clinical practice, stratified management protocols should be implemented for paediatric populations at high risk of AAD.

RELEVANCE TO CLINICAL PRACTICE: Core components of such protocols include optimising antibiotic selection and treatment duration, initiating early combined probiotic interventions and enhancing intestinal function monitoring.