MANAGEMENT AND OUTCOMES OF HOSPITALISED CHILDREN WITH COMMUNITY-ACQUIRED PNEUMONIA COMPLICATED BY PLEURAL EFFUSION

Abstract: The aim of this study was to investigate the hospitalisation of children with community-acquired pneumonia complicated by pleural effusion. Children without significant comorbidities, aged less than 18 years, admitted between 1 February 2022 and 25 February 2025 to the pulmonology and surgery departments of the SRChMMC with any pneumonia discharge code, who had an ultrasound findings of effusion/empyema, were studied. During the study period, 87 children without serious comorbidities were hospitalised for confirmed EP. The mean length of hospital stay was 9 days (Q1-Q3 6-11 days), 27 (31 %) were hospitalised in ORIT. Most (61, 70%) underwent procedural drainage. Length of hospital stay was not related to the amount of effusion but was associated with the time of drainage (0.60 days longer stay per day of delayed drainage, 95% CI 0.19-1.0 days). Microbiological diagnosis was more frequently made by PCR analysis of pleural fluid (43/59, 73%) than by blood culture (9, 10%); the main aetiological pathogens were S. pneumoniae (33, 38%), S. pyogenes (14, 87%) and S. aureus (7, 8%). Discharge on a narrow-spectrum antibiotic (e.g., amoxicillin) was much more common when a pathogen with complicated pleural effusion was identified than when it was not (68% vs. 24%, p < 0.001). Thus, children with OPV were usually hospitalised for prolonged periods. Surgical procedural drainage was associated with a shorter hospital stay. Examination of pleural fluid often facilitated microbiological diagnosis, which itself was associated with more adequate antibiotic therapy.