Uncomplicated community-acquired pneumonia (CAP) in young children is most often caused by viruses, yet several guidelines recommend antibiotic treatment for all children hospitalized with this condition. A retrospective observational study was conducted to determine the proportion of children ages three months to three years hospitalized with uncomplicated CAP who didn't receive antibiotics and to compare clinical outcomes in these children with outcomes in children who did receive antibiotics.

Administrative data and hospital records were used to identify children ages three to 36 months without underlying comorbidities who were hospitalized with uncomplicated CAP from 2011 to 2019. Patients were considered to be treated if they received antibiotics for more than two days as inpatients or at discharge; those who were considered to be not treated had received antibiotics for two days or fewer as inpatients and no antibiotics at discharge. Demographic and clinical characteristics of the two groups were similar.

Of the 322 children included in the study population, 266 (83%) were treated or discharged home with antibiotics. Similar proportions of patients in both groups required care in the ICU during hospitalization. There were no statistically significant differences between the groups in terms of median length of hospital stay or 30-day readmissions. Although there were no active efforts in the study hospital to reduce antibiotic treatment of CAP, the use of antibiotics declined from 88% in 2011-2013 to 66% in 2017-2019.

The results suggest that many young children who have uncomplicated CAP can be treated without antibiotics. Better tools are needed to identify these children, the researchers conclude.