CHOP to study antibiotic delivery to children after hospitalization for serious bacterial infection

The Children's Hospital of Philadelphia (CHOP) was awarded nearly $2M in research funding from the Patient-Centered Outcomes Research Institute (PCORI) to study antibiotic delivery to children returning home after hospitalization for a severe bacterial infection.

The CHOP research is one of 25 projects totaling $40.7M selected from a pool of 500 applicants by PCORI's Board of Governors following a competitive, multi-stage review process involving scientists, patients, caregivers and other stakeholders. Proposals were evaluated on the basis of scientific merit, engagement of patients and stakeholders, methodological rigor and fit within PCORI's National Priorities for Research and Research Agenda.

When a child hospitalized with a serious bacterial infection is discharged, clinicians have two options: (1) transition from the intravenous antibiotics used in the hospital to a prolonged course of oral antibiotics at home; or (2) insert a central venous catheter (PICC) into a large vein in the chest and train the parents in care of the PICC and administration of intravenous antibiotics at home. "These two antibiotic treatment options have major implications for the overall experience of the child, families and caregivers, but there is a lack of real-world evidence on their benefits and drawbacks to help clinicians and patient families make an informed choice," said Ron Keren, MD, MPH, who is leading the study and also directs the Center for Pediatric Clinical Effectiveness (CPCE) at CHOP. "If we find that the prolonged IV option is no better than the oral route, we think that most families would prefer for their child to take oral antibiotics."

In addition to studying the risks and benefits to each treatment choice, the research team will also include parent-investigators, who will inform the research questions being asked and advise the team on how best to communicate the pros and cons of each treatment option to parents.

"The announcement of funding for studies like this one mark a major milestone in our work as we build a portfolio of comparative clinical effectiveness research that will provide patients and those who care for them better information about the health care decisions they face," said PCORI Executive Director Joe Selby, MD, MPH. "These research projects reflect PCORI's patient-centered research agenda, emphasizing the inclusion of patients and caregivers at all stages of the research."