Trends in Use of Postdischarge Intravenous Antibiotic Therapy for Children

Children with complicated appendicitis, osteomyelitis, and complicated pneumonia have historically been treated with postdischarge intravenous antibiotics (PD‐IV) using peripherally inserted central catheters (PICCs). Recent studies have shown no advantage and increased complications of PD‐IV, compared with oral therapy, and the extent to which use of PD‐IV has since changed for these conditions is not known. We used a national children's hospital database to evaluate trends in PD‐IV during 2000‐2018 for each of these three conditions. PD‐IV decreased from 13% to 2% (risk ratio [RR], 0.15; 95% CI, 0.14‐0.16) for complicated appendicitis, 61% to 22% (RR, 0.41; 95% CI, 0.39‐0.43) for osteomyelitis, and 29% to 19% (RR, 0.63; 95% CI, 0.58‐0.69) for complicated pneumonia. Despite these overall reductions, substantial variation in PD‐IV use by hospital remains in 2018.