578 - Experiences of Hospitalized Children and Caregivers with IV and Oral Antibiotics for Pneumonia

Publication Number: 2563.578

Jillian Cotter, University of Colorado School of Medicine, Aurora, CO, United States; Catia Chavez, University of Colorado School of Medicine, Aurora, CO, United States; Steven Lockhart, University of Colorado, Anschutz, Aurora, CO, United States; Lilliam Ambroggio, Children's Hospital Colorado, Aurora, CO, United States; Allison Kempe, University of Colorado AMC and ACCORDS, denver, CO, United States; Christina Studts, University of Colorado School of Medicine, Aurora, CO, United States; Brooke Dorsey, University of Colorado School of Medicine, Aurora, CO, United States

Background: Antibiotic delivery route-oral versus intravenous (IV)-can impact the hospital experience for children hospitalized with pneumonia and their caregivers. Yet, the emotional and practical implications of these routes remain underexplored.

Objective: To describe nurses' and caregivers' perspectives on patients' and caregivers' experiences with oral and IV antibiotic administration for pneumonia.

Design/Methods: We conducted a qualitative study using semi-structured interviews with caregivers of non-medically complex, non-critically ill children hospitalized with pneumonia within the previous 30 days and with pediatric nurses working in emergency and inpatient settings at a children's hospital from 12/2024-5/2025. We used purposive sampling, and all interviews were conducted via Zoom or telephone, audio-recorded, and professionally transcribed. Interviews were analyzed by two investigators using rapid qualitative analysis to identify themes, and we continued until thematic saturation was reached.

Results: We interviewed 10 caregivers and 10 nurses (Table 1). Three key themes emerged (Table 2): (1) Peripheral IV catheter (PIV) placement causes significant pain and emotional distress for children and families. (2) After PIV placement, minimal pain but practical and emotional burdens of IV antibiotics and the PIV persist for many caregivers and children. These include challenges with mobility restrictions during antibiotic infusions, caregiver worries about catheter integrity and complications, and stress from alarms. Some nurses noted lasting psychological impacts of PIV insertion on children, and one caregiver shared that antibiotic route selection influences their perception of their child's illness severity. (3) Oral antibiotics are typically easier, safer and less distressing - but not without some challenges. Some children have difficulty swallowing or resist taking oral medications, which can offset some of these advantages.

Conclusion(s): Caregivers and nurses described significant emotional and practical burdens associated with IV antibiotic administration, particularly related to PIV placement, and generally more favorable experiences with oral antibiotics due to their ease and reduced distress. Given the comparable clinical effectiveness of oral and IV antibiotics for pediatric pneumonia, clinicians should consider these experiences when discussing treatment options with families and when making antibiotic route decisions.

Table 1. Participant Characteristics
na, not applicable

Table 2. Themes from Caregivers and Nurses
ED, emergency department; IP, inpatient