Study Identifies Challenges to Halting Use of Antibiotics for Viral Pneumonia in Young Children

The study “Parent and Clinician Views on Not Using Antibiotics for Mild Community-Acquired Pneumonia” suggests de-implementing the use of antibiotics for viral pneumonia in young children poses challenges. The qualitative study in the February 2024 edition of Pediatrics (published online Jan. 18) used semi-structured interviews with 38 respondents (18 parents, 20 clinicians). Although both parents and clinicians expressed broad support for the judicious use of antibiotics, the study revealed obstacles to putting that into practice. Diagnostic uncertainty, fear of respiratory symptoms in young children, contextual factors surrounding the clinical encounter, and consequences of undertreating a bacterial infection were cited as hurdles to limiting the use of antibiotics for mild community-acquired pneumonia in young children. For parents, disagreeing with the assessment of “mild” pneumonia, meaning they perceive their child to be more ill than the clinician does, also contributes to a willingness to accept the risks of antibiotics even if there is a low likelihood they are needed. Using antibiotics when they are not needed can expose children to adverse effects and potentially severe complications, and lead to antibiotic resistance. Parents interviewed for the study noted they could be receptive to not receiving antibiotics for their child if there is trust in the clinician, communication of a clear rationale for the approach, and description of a contingency plan. Authors of the study say changing the care of children with pneumonia would require a cultural shift for both clinicians and families.

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.