1466. Adherence to Empiric Treatment Recommended by IDSA/PIDS Pediatric Community-Acquired Pneumonia (CAP) Guidelines According to Immunization Status

BACKGROUND: Current pediatric CAP guidelines recommend empiric antibiotic treatment based on patient’s immunization status against Haemophilus influenzae and Streptococcus pneumoniae. The primary objective of this study was to assess the current empiric antimicrobial treatment practices for CAP based on the immunization status of pediatric patients. METHODS: This retrospective cohort included pediatric patients diagnosed with CAP and received initial empiric antibiotics after presenting to the institution. The cohorts were categorized as fully immunized or not fully immunized consistent with state immunization health records and national recommendations according to the child’s age. The primary outcome was receipt of appropriate vs. inappropriate antibiotics according to guideline recommendations. Multivariable analyses were used to evaluate inappropriate empiric antibiotics for CAP with immunizations status as exposure of interest. Secondary outcomes included length of stay and 30-day readmission rates. RESULTS: A total of 189 patients (129 fully immunized and 60 not fully-immunized) were included in the interim analysis. A total of 104 patients (55%) received inappropriate antibiotics [62 of the fully immunized (48%) and 42 of the not fully immunized (70%) received inappropriate antibiotics (P = 0.0048)]. Multivariable analysis identified not fully-immunized and age as independent predictors for inappropriate empiric antibiotics for CAP, aOR 2.77, 95% CI (1.20, 5.89), P = 0.008, and aOR 1.41, 95% CI (1.15, 1.72), P = 0.001; respectively. In terms of secondary outcomes, not fully-immunized patients had longer length of stay, higher readmission in 30 days, and greater need for oxygen supplementation, but none of these results were statistically significant. CONCLUSION: Currently, the majority of pediatric patients treated for CAP received inappropriate empiric antibiotics. Not fully-immunized patients were more likely to receive inappropriate empiric antibiotics for CAP and subsequently did not have improved morbidity. DISCLOSURES: All authors: No reported disclosures.