[Safety of a clinical prediction rule for initial management of children with pneumonia in an ambulatory setting].
BACKGROUND
Despite many cases of pneumonia in children are due to viruses, initial management includes antibiotics. To avoid unnecessary antibiotic use, a clinical rule to predict etiology in children hospitalized for pneumonia was developed (BPS: Bacterial Pneumonia Score), but it performance in ambulatory settings has not been yet tested. We aimed to evaluate the safety of using BPS in children with pneumonia in an ambulatory setting.


METHODS
This cohort study included children aged 3-60 months, assisted for pneumonias as outpatients. BPS (range: -3 to 15 points) was calculated in all of them, and only those with ≥ 4 points received antibiotics. Clinical outcome was evaluated 1, 2, 3, 5, 7, and 10 days after the first visit.


RESULTS
108 patients were included, aged 25.3 ± 16.5 months. From them, 48 (44.4%) showed BPS ≥ 4, and received antibiotics. After 10 days, there were no differences in clinical outcome between groups (with and without antibiotics) (p = 0.5; RR: 0.39; IC 95%: 0.01-5.74). Only 3 patients showed unsatisfactory clinical outcome; 1 of them had not received antibiotics.


CONCLUSIONS
Using BPS was safe for initial management of children with pneumonia in an outpatient setting.
Departamento de Consultorios Externos, Hospital General de Niños Pedro de Elizalde. torresf@intramed.net
Fernando A
FA
Torres
Irma
I
Passarelli
Adrián
A
Cutri
Araceli
A
Leonardelli
María F
MF
Ossorio
Fernando
F
Ferrero
D000553:Ambulatory Care; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D011014:Pneumonia / Q000382:microbiology* / Q000628:therapy*; D011237:Predictive Value of Tests; D011446:Prospective Studies