Children with neurologic impairment (NI) are at increased risk of recurrent pneumonia. What can we do to help prevent this from happening? Lin et al. (10.1542/peds.2019-0543) looked at 8 different prevention strategies to see if they reduced hospitalizations for recurrent pneumonia. The authors studied 3,632 children with NI and an index hospitalization for pneumonia, and then followed 1,362 who were readmitted with subsequent pneumonia between 2009 and 2014. They reviewed records of these children to see if they had received any of the following: dental care, oral secretion management, gastric acid suppression, placement of a gastrostomy tube, chest physiotherapy, outpatient antibiotics prior to the index admission, or an outpatient visit prior to or after discharge from their index hospitalization. So which of these worked??
Only one strategy reduced the odds of a subsequent pneumonia hospitalization—and that was receiving dental care. At least five of the strategies were associated with increased odds for another pneumonia. To find out which and to better understand why receiving dental care reduced the odds of recurrent pneumonia, and the other 7 strategies did not, strategize a plan to read this study and then make sure your patients with NI are getting the dental hygiene all children need to receive. Doing so will hopefully reduce your rates of readmission for recurrent pneumonia in children with NI, as they did in this study.
