Pediatric Research in Inpatient Settings Network

Project Summary

When clinicians want to prescribe prolonged antibiotic therapy for children who have been
hospitalized with a serious bacterial infection they have two options: (1) discontinue the intravenous
antibiotics and discharge the child to receive a prolonged course of oral antibiotics at home; or (2) insert
a central venous catheter (usually a peripherally inserted central catheter (PICC)), train the parents in
care of the PICC and administration of intravenous antibiotics, and discharge the child to receive a
prolonged course of intravenous antibiotics via the central venous catheter at home. These two options
have major implications for the overall experience of the child and their caregiver, but there is a paucity
of evidence on their comparative effectiveness to help clinicians, patients, and their caregivers make an
informed choice.

Specific Aim #1
To compare the effectiveness of oral antibiotics vs. intravenous (IV) antibiotics delivered via a PICC in
children who require prolonged (at least 1 week) home antibiotic therapy after hospitalization for a
serious bacterial infection.

Specific Aim #2
To compare patient and caregiver reported quality of life and adherence to therapy for oral antibiotics
vs. IV antibiotics delivered via a PICC in children who require prolonged home antibiotic therapy after
hospitalization for a serious bacterial infection.

Objectives

In this proposal we outline a series of projects to compare oral antibiotics vs. intravenous
antibiotics delivered via a central venous catheter in children who require prolonged (at least 1 week)
home antibiotic therapy after hospitalization for three different serious bacterial infections: perforated
appendicitis, complicated pneumonia, and osteomyelitis.

Funding

Patient Centered Outcomes Research (PCORI)