Sequential antimicrobial therapy: treatment of severe lower respiratory tract infections in children

Although there have been a number of studies in adults, to date there has b een little research into sequential antimicrobial therapy (SAT) in paediatr ic populations. The present study evaluates the impact of a SAT protocol fo r the treatment of severe lower respiratory tract infection in paediatric p atients. The study involved 89 paediatric patients (44 control and 45 SAT). The SAT patients had a shorter length of hospital stay (4.0 versus 8.3 day s), shorter duration of inpatient antimicrobial therapy (4.0 versus 7.9 day s) with the period of iv therapy being reduced from a mean of 5.6 to 1.7 da ys. The total healthcare costs were reduced by 52%. The resolution of sever e lower respiratory tract infection with a short course of iv antimicrobial s, followed by conversion to oral therapy yielded clinical outcomes compara ble to those achieved using longer term iv therapy. SAT proved to be an imp ortant cost-minimizing tool for realizing substantial healthcare costs savi ngs.