Intravenous line‐related outcomes by antibiotic route for children hospitalized with pneumonia

We evaluated whether peripheral intravenous catheter (PIV) utilization and complications (i.e., infiltration/extravasation) differed between children hospitalized with pneumonia who received initial oral versus intravenous antibiotics. In a retrospective cohort study of children hospitalized with pneumonia at four affiliated sites within a single hospital system from 2014 to 2020, we evaluated PIV outcomes and compared them using bivariable analyses and multivariable regression models. Among 1035 children, 65% received initial oral antibiotics and 59% had PIVs. PIVs were placed in 38% of children with oral antibiotics and 99% with IV antibiotics. Infiltration/extravasation occurred in 1% of children with oral antibiotics and 9% with IV antibiotics. Among children with PIVs, those with oral antibiotics had lower odds of infiltration/extravasation (odds ratio [OR]: 0.39, 95% confidence interval [CI]: 0.17-0.9). Given the pain and anxiety of PIVs for children and the morbidity associated with infiltrations/extravasations, initial oral antibiotics provide an opportunity to improve patient and family experiences and minimize PIV-related harms.