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Keywords:

  • Children;
  • Community-acquired pneumonia;
  • Epidemiology;
  • Lung abscess;
  • Pleural empyema

Abstract

Aim:  To identify the baseline characteristics associated with suppurative complications in children with community-acquired primary pneumonia.

Methods:  A retrospective study included all children from 28 days to 15 years old, who presented with community-acquired pneumonia at two French hospitals from 1995 to 2003. Complicated pneumonia was defined by the presence of empyema and/or lung abscess.

Results:  Of 767 children with community-acquired pneumonia, 90 had suppurative complications: 83 cases of pleural empyema and seven cases of lung abscess. The mean prevalence of complicated pneumonia was 3% during the 1995–1998 period, and then steadily increased following a linear trend to reach 23% in 2003. Children with complicated pneumonia were older and had a longer symptomatic period preceding hospitalization. They were more likely to receive antibiotics, especially aminopenicillins (p < 0.01), and nonsteroidal anti-inflammatory drugs, especially ibuprofen (p < 0.001). In multivariable analysis, ibuprofen was the only preadmission therapy that was independently associated with complicated pneumonia [adjusted OR = 2.57 (1.51–4.35)].

Conclusion: This study confirms an association between the use of prehospital ibruprofen and suppurative pneumonic complications.