{
  "abstract": "Objective As children hospitalised with community-acquired pneumonia (CAP) are at risk of persistent chest radiograph (CXR) abnormalities and respiratory sequelae, we investigated factors associated with incomplete CXR resolution at 4 weeks and 12 months post-discharge in children from populations at high-risk of chronic lung disease.Design Secondary analysis−multicentre, placebo-controlled, randomised controlled trial.Settings and patients 324 children aged 3 months to ≤5 years hospitalised with radiographic-confirmed CAP were enrolled from seven hospitals in Australia, New Zealand and Malaysia. After 1–3 days of intravenous antibiotics, then 3 days of oral amoxicillin–clavulanate, they were randomised to extended (13–14 days) or standard (5–6 days) courses of antibiotics.Intervention CXRs were performed at admission, 4 weeks, and 12 months post-discharge and reviewed in a blinded manner.Main outcome measures Radiographic changes of pneumonia at 4 weeks and 12 months post-discharge compared with admission CXRs.Results Among children with interpretable CXRs, incomplete resolution was seen in 42/253 (17%) at 4 weeks, and 29/212 (14%) at 12 months. Characteristics at admission associated with incomplete CXR resolution at 4 weeks were previous pneumonia hospitalisation (adjusted odds ratio [OR adj])=6.46, 95% confidence interval [CI] 2.21 to 18.85) and increasing age (ORadj=0.60 per-year, 95% CI 0.38 to 0.94). Continuing respiratory symptoms/signs at 4 weeks post-discharge was also associated with incomplete resolution (OR=5.63, 95% CI 2.38 to 13.32). At 12 months, previous pneumonia hospitalisation was associated with persistent incomplete CXR resolution (OR=4.03, 95 % CI 1.25 to 13.02).Conclusion In high-risk settings, younger age, those with previous pneumonia hospitalisation, or ongoing respiratory symptoms/signs 4 weeks post-discharge from hospitalised CAP may be associated with incomplete CXR resolution. Consequently, follow-up imaging and monitoring may be warranted in these children.",
  "authors": [
    {
      "affiliations": [
        "Child and Maternal Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia",
        "Department of Paediatrics, Sabah Women and Children’s Hospital, Kota Kinabalu, Sabah, Malaysia",
        "Australian Centre for Health Services Innovation and School of Medicine, Queensland University of Technology, Brisbane, Queensland, Australia"
      ],
      "name": "Hing Cheong Kok"
    },
    {
      "affiliations": [
        "Child and Maternal Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia",
        "Australian Centre for Health Services Innovation and School of Medicine, Queensland University of Technology, Brisbane, Queensland, Australia"
      ],
      "name": "Stephanie T Yerkovich"
    },
    {
      "affiliations": [
        "Child and Maternal Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia"
      ],
      "name": "Gabrielle B McCallum"
    },
    {
      "affiliations": [
        "Child and Maternal Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia",
        "Departments of Infectious Diseases and Paediatrics, Gold Coast Health, Gold Coast, Queensland, Australia",
        "School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia"
      ],
      "name": "Keith Grimwood"
    },
    {
      "affiliations": [
        "Australian Centre for Health Services Innovation and School of Medicine, Queensland University of Technology, Brisbane, Queensland, Australia",
        "Department of Respiratory and Sleep Medicine, Queensland Children’s Hospital, Brisbane, Queensland, Australia"
      ],
      "name": "Ian Brent Masters"
    },
    {
      "affiliations": [
        "Child and Maternal Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia",
        "Sydney Children’s Hospital at Westmead, Sydney, New South Wales, Australia"
      ],
      "name": "Nicholas Fancourt"
    },
    {
      "affiliations": [
        "Department of Paediatrics, Sabah Women and Children’s Hospital, Kota Kinabalu, Sabah, Malaysia"
      ],
      "name": "Siew Moy Fong"
    },
    {
      "affiliations": [
        "Department of Paediatrics, Universiti of Malaya, Kuala Lumpur, Malaysia"
      ],
      "name": "Anna M Nathan"
    },
    {
      "affiliations": [
        "Respiratory Department, Starship Children’s Hospital, Auckland, New Zealand",
        "Department of Paediatrics, University of Auckland, Auckland, New Zealand"
      ],
      "name": "Catherine A Byrnes"
    },
    {
      "affiliations": [
        "School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia"
      ],
      "name": "Robert S Ware"
    },
    {
      "affiliations": [
        "Department of Paediatrics, Tengku Ampuan Rahimah Hospital, Klang, Selangor, Malaysia"
      ],
      "name": "Nachal Nachiappan"
    },
    {
      "affiliations": [
        "Department of Paediatrics, Tengku Ampuan Rahimah Hospital, Klang, Selangor, Malaysia"
      ],
      "name": "Noorazlina Saari"
    },
    {
      "affiliations": [
        "Child and Maternal Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia",
        "Department of Paediatrics, Royal Darwin Hospital, Darwin, Northern Territory, Australia"
      ],
      "name": "Peter S Morris"
    },
    {
      "affiliations": [
        "Child and Maternal Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia",
        "Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore"
      ],
      "name": "Tsin Wen Yeo"
    },
    {
      "affiliations": [
        "Child and Maternal Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia",
        "Poche Centre for Indigenous Health, The University of Queensland, Brisbane, Queensland, Australia"
      ],
      "name": "Victor M Oguoma"
    },
    {
      "affiliations": [
        "Department of Paediatrics, Universiti of Malaya, Kuala Lumpur, Malaysia"
      ],
      "name": "Jessie Anne de Bruyne"
    },
    {
      "affiliations": [
        "Department of Paediatrics, Universiti of Malaya, Kuala Lumpur, Malaysia"
      ],
      "name": "Kah Peng Eg"
    },
    {
      "affiliations": [
        "Child and Maternal Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia",
        "First Nations Leadership & Engagement, Charles Darwin University, Darwin, Northern Territory, Australia"
      ],
      "name": "Bilawara Lee"
    },
    {
      "affiliations": [
        "Department of Paediatrics, Sarawak General Hospital, Kuching, Sarawak, Malaysia",
        "Institute of Health and Community Medicine, Universiti Malaysia Sarawak, Sarawak, Malaysia"
      ],
      "name": "Mong How Ooi"
    },
    {
      "affiliations": [
        "Frazer Institute, The University of Queensland and Translational Research Institute, Brisbane, Queensland, Australia"
      ],
      "name": "John W Upham"
    },
    {
      "affiliations": [
        "Central Clinical School, University of Sydney, Sydney, New South Wales, Australia",
        "Department of Respiratory Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia"
      ],
      "name": "Paul J Torzillo"
    },
    {
      "affiliations": [
        "Child and Maternal Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia",
        "Australian Centre for Health Services Innovation and School of Medicine, Queensland University of Technology, Brisbane, Queensland, Australia",
        "Department of Respiratory and Sleep Medicine, Queensland Children’s Hospital, Brisbane, Queensland, Australia"
      ],
      "name": "Anne B Chang"
    }
  ],
  "title": "Association between hospitalised childhood pneumonia and follow-up chest radiographs in high-risk populations: a secondary analysis of a multicentre randomised controlled trial",
  "uid": "9f156732-04c1-59d7-ab46-f3c48093c133"
}