Immunity, inflammation and disease · 2026
Antibiotic Therapy and Factors Predicting Prolonged Hospitalization Among Children Under Three Years Diagnosed With Respiratory Syncytial Virus-Associated Lower Respiratory Infection.
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Asseri Ali Alsuheel
Аннотация
BACKGROUND: Respiratory syncytial virus (RSV) is a common cause of lower respiratory infections (LRIs) in infants and young children. Antibiotic overuse remains a significant concern in hospitalized children with RSV-associated LRIs. This study aimed to investigate the prevalence of antibiotic use and identify predictors of prolonged hospitalization in children with RSV-LRIs.
METHODS: A retrospective record review study was conducted at Abha Maternity and Children's Hospital, enrolling 162 children aged 1-36 months admitted with RSV-associated LRIs between January and December 2022. Demographic, clinical, laboratory, and imaging data were collected. Antibiotic therapy and hospital length of stay (LOS) were also retrieved and analyzed.
RESULTS: Of the 162 patients, 147 (90.74%) received antibiotic therapy, with azithromycin, cefuroxime, and ceftriaxone being the most commonly used. Patients who received antibiotics had a significantly longer median LOS compared to those who did not (6 vs. 3 days, p < 0.001). Factors associated with prolonged LOS (≥ 5 days) included antibiotic therapy use (odds ratio [OR] = 7.47 (95% confidence intervals [CI]: 2.18-25.57), pneumonia: OR = 3.58 (95% CI: 1.67-7.67), age < 12 months: OR = 2.80 (95% CI: 1.32-5.89), consolidation: OR = 2.54 (95% CI: 1.16-5.59), age in months: OR = 0.94 (95% CI: 0.91-0.98) (indicates decreasing odds with increasing age), admission respiratory rate: OR = 1.04 (95% CI: 1.01-1.07), and admission peripheral oxygen saturation (SpO2): OR = 0.91 (95% CI: 0.86-0.97) (indicates decreasing odds with higher SpO2).
CONCLUSION: The high prevalence of antibiotic use in this study highlights the challenges in differentiating RSV-LRIs from bacterial pneumonia. Independent predictors of prolonged hospital stay included antibiotic therapy, pneumonia, younger age, lower admission SpO₂, and higher respiratory rate.
METHODS: A retrospective record review study was conducted at Abha Maternity and Children's Hospital, enrolling 162 children aged 1-36 months admitted with RSV-associated LRIs between January and December 2022. Demographic, clinical, laboratory, and imaging data were collected. Antibiotic therapy and hospital length of stay (LOS) were also retrieved and analyzed.
RESULTS: Of the 162 patients, 147 (90.74%) received antibiotic therapy, with azithromycin, cefuroxime, and ceftriaxone being the most commonly used. Patients who received antibiotics had a significantly longer median LOS compared to those who did not (6 vs. 3 days, p < 0.001). Factors associated with prolonged LOS (≥ 5 days) included antibiotic therapy use (odds ratio [OR] = 7.47 (95% confidence intervals [CI]: 2.18-25.57), pneumonia: OR = 3.58 (95% CI: 1.67-7.67), age < 12 months: OR = 2.80 (95% CI: 1.32-5.89), consolidation: OR = 2.54 (95% CI: 1.16-5.59), age in months: OR = 0.94 (95% CI: 0.91-0.98) (indicates decreasing odds with increasing age), admission respiratory rate: OR = 1.04 (95% CI: 1.01-1.07), and admission peripheral oxygen saturation (SpO2): OR = 0.91 (95% CI: 0.86-0.97) (indicates decreasing odds with higher SpO2).
CONCLUSION: The high prevalence of antibiotic use in this study highlights the challenges in differentiating RSV-LRIs from bacterial pneumonia. Independent predictors of prolonged hospital stay included antibiotic therapy, pneumonia, younger age, lower admission SpO₂, and higher respiratory rate.