Basnet et al reported predictors for treatment failure in a young child hospitalized for severe pneumonia. These can help to identify a patient who may require more aggressive management. The authors are from Tribhuvan University, University of Bergen, University Hospital of North Northway, Kathmandu University, Statens Serum Institut and Innlandet Hospital Trust.
Patient selection: 2-35 months, severe pneumonia, resource-poor setting (Nepal)
Outcomes: treatment failure, prolonged recovery time
Treatment failure was defined as:
(1) change to second line antibiotic
(2) failure to improve
(3) complications (empyema, pneumothorax, admission to ICU)
Predictors:
(1) age 2-6 months (aOR 1.0 vs 0.2 to 0.6 for older ages)
(2) hypoxia (SpO2 < 90%; aOR 1.8 to 2.0 depending on model)
(3) consolidation on admission chest X-ray (aOR 2.1)
The risk increases with the number of predictors present.
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