Comparison of Short‐ vs Long‐Course Antibiotic Therapy for Children With Tracheitis Associated With an Artificial Airway

ABSTRACT Objective Limiting antibiotic days for treatment of tracheitis to the shortest, most effective duration is an important antimicrobial stewardship endeavor. The objective was to compare outcomes between patients who received a short course of antibiotics to those receiving a longer course. Methods This is a retrospective, cohort evaluation of patients admitted to the pediatric intensive care unit with an artificial airway and prescribed a course of antibiotics for at least 3 days for tracheitis. We compared the rate of re‐treatment of tracheitis or development of new pneumonia requiring antibiotics within 10 days of completing therapy between patients receiving a short course (≤ 6 days) or long course (≥ 7 days) of antibiotics for tracheitis. We also compared the rate of developing a subsequent multi‐drug resistant organism within 30 days of completing therapy between groups. Results A total of 95 patients were included; 42 (44%) patients received short (median 5 days) duration antibiotic therapy and 53 (56%) patients received long (median 9 days) duration. Duration of therapy did not statistically impact the composite of need for re‐treatment of tracheitis or development of pneumonia within 10 days or all‐cause mortality within 30 days of completing antibiotics. Conclusions Shorter courses do not have worse outcomes compared to longer courses. Pediatric providers should be encouraged to limit treatment duration for tracheitis to 5 days.