Children with neurologic impairment had lower rates of recurrent severe pneumonia if they practiced dental care as a preventive measure, according to the results of a study published in the journal Pediatrics.
The rate of pneumonia hospitalization for children enrolled in California Children’s Services was evaluated and a comparison of rates among expert-recommended prevention strategies was made. The prevention strategies of interest were dental care, oral secretion management, gastric acid suppression, gastrostomy tube placement, chest physiotherapy, outpatient antibiotics before index hospitalization, and clinic visit before or after index hospitalization.
Among the 3632 children with neurologic impairment hospitalized for pneumonia, 1362 had a subsequent hospitalization for pneumonia. Of all the expert-recommended prevention strategies, only dental care was associated with decreased risk for subsequent pneumonia hospitalization (adjusted odds ratio, 0.64). Furthermore, exposures associated with increased risk for subsequent hospitalizations included gastrostomy tube placement, chest physiotherapy, outpatient antibiotics before hospitalization, and clinic visits before and after index hospitalization.
“Of the many pneumonia prevention strategies recommended by expert guidelines, only dental care appears to have potentially protective effects against severe pneumonia among children with [neurologic impairment],” the researchers wrote. “Our findings support a clinical trial of dental care for prevention of severe pneumonia in children with [neurologic impairment] and do not support the widespread use of gastrostomy tubes for that purpose.”
Lin JL, Van Haren K, Rigdon J, et al. Pneumonia prevention strategies for children with neurologic impairment [published online September 19, 2019]. Pediatrics. doi:10.1542/peds.2019-0543