Prevalence and risk factors of suppurative complications in children with pneumonia.
OBJECTIVE
To identify the baseline characteristics associated with suppurative complications in children with community-acquired primary pneumonia.


METHODS
A retrospective study included all children from 28 days to 15 years old, who presented with community-acquired pneumonia at two French hospitals from 1995 to 2003. Complicated pneumonia was defined by the presence of empyema and/or lung abscess.


RESULTS
Of 767 children with community-acquired pneumonia, 90 had suppurative complications: 83 cases of pleural empyema and seven cases of lung abscess. The mean prevalence of complicated pneumonia was 3% during the 1995-1998 period, and then steadily increased following a linear trend to reach 23% in 2003. Children with complicated pneumonia were older and had a longer symptomatic period preceding hospitalization. They were more likely to receive antibiotics, especially aminopenicillins (p < 0.01), and nonsteroidal anti-inflammatory drugs, especially ibuprofen (p < 0.001). In multivariable analysis, ibuprofen was the only preadmission therapy that was independently associated with complicated pneumonia [adjusted OR = 2.57 (1.51-4.35)].


CONCLUSIONS
This study confirms an association between the use of prehospital ibuprofen and suppurative pneumonic complications.
François
Patrice
P
Quality of Care Unit, Centre Hospitalier Universitaire de Grenoble, Grenoble, France. pfrancois@chu-grenoble.fr
Desrumaux
Amélie
A
Cans
Christine
C
Pin
Isabelle
I
Pavese
Patricia
P
Labarère
José
J
D000293:Adolescent; D000367:Age Factors; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections; D004653:Empyema / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005602:France / Q000453:epidemiology; D006760:Hospitalization; D006801:Humans; D007052:Ibuprofen / Q000009:adverse effects*; D007223:Infant; D008169:Lung Abscess / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D015999:Multivariate Analysis; D011014:Pneumonia / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors
D000894:Anti-Inflammatory Agents, Non-Steroidal; D007052:Ibuprofen