Comparison of Short‐ vs Long‐Course Antibiotic Therapy for Children With Tracheitis Associated With an Artificial Airway

OBJECTIVE: Limiting antibiotic days for treatment of tracheitis to the shortest, most effective duration is an important antimicrobial stewardship endeavor. The objective was to compare outcomes between patients who received a short course of antibiotics to those receiving a longer course. METHODS: This is a retrospective, cohort evaluation of patients admitted to the pediatric intensive care unit with an artificial airway and prescribed a course of antibiotics for at least 3 days for tracheitis. We compared the rate of re-treatment of tracheitis or development of new pneumonia requiring antibiotics within 10 days of completing therapy between patients receiving a short course (≤ 6 days) or long course (≥ 7 days) of antibiotics for tracheitis. We also compared the rate of developing a subsequent multi-drug resistant organism within 30 days of completing therapy between groups. RESULTS: A total of 95 patients were included; 42 (44%) patients received short (median 5 days) duration antibiotic therapy and 53 (56%) patients received long (median 9 days) duration. Duration of therapy did not statistically impact the composite of need for re-treatment of tracheitis or development of pneumonia within 10 days or all-cause mortality within 30 days of completing antibiotics. CONCLUSIONS: Shorter courses do not have worse outcomes compared to longer courses. Pediatric providers should be encouraged to limit treatment duration for tracheitis to 5 days.