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G162(P) Is antibiotic usage among children admitted for community acquired pneumonia (CAP) associated with seasonal variation?

Aims Primary objective is to analyse antibiotic usage among children admitted for CAP comparing summer and winter seasons in 2017–2018. Secondary objective is to determine other factors associated with antibiotic prescription. Methods This is a retrospective audit study conducted in a district general hospital. Chest X-rays (CXR) performed on children aged 1 month to 16 years old admitted in summer (1/6/2017–31/8/2017) and winter (1/12/2017–28/2/2018) were retrieved and reviewed along with their reports. Patients’ admission data was collected from electronic discharge notes using a standard case report form in Excel format. Children with diagnosis of CAP supported by presence of CXR changes and/or clinical features of pneumonia were included. Results 118/1410 (8.4%) children were hospitalised in summer and 321/1508 (21.3%) in winter for CAP (p<0.0001), of which 49 and 51 admissions were analysed respectively. 79% (79/100) received antibiotic; Co-Amoxiclav 37/79 (47%), Ceftriaxone 18/79 (23%), Amoxicillin 9/79 (11%) and Macrolide 9/79 (11%). Initiation, duration, choice and decision to use combination of antibacterial were not significantly associated with seasonal variation, presence of comorbidity and CXR appearance. Median age of children who received antibiotic was 2 years old and median age of children who did not was 1 year old (p=0.01). Prescription of Ceftriaxone was significantly associated with longer hospital stay and antibiotic duration (table 1).Abstract G162(P) Table 1 Admission antibiotic (n) p-value Amoxicillin Co-Amoxiclav Ceftriaxone Macrolide Other Medianage (years) 1.0 2.0 2.0 5.0 5.5 0.026 Median length of stay (days) 1 2 3 1 2.5 0.005 Median antibiotic duration 5 (8) 5 (34) 7 (15) 5 (9) 6.5 (2) 0.008 Conclusion Broad spectrum antibiotic (Co-Amoxiclav, Ceftriaxone) prescription was substantially high among children admitted for CAP. Seasonal variation did not seem to have impact on antibiotic usage among in-patient childhood CAP in our centre. This may indicate that high volume of childhood CAP admissions in winter months does not affect decision making on antibiotic usage.