Table 1.
Demographics and clinical features of the children according to their compliance with recommendations and period of the study (numbers are percentages with denominators mentioned at the top of the column, except for those with superscript letters) with univariate and multivariate analyses for factors associated with prescription non-compliance (by period)
| Period 1 | Period 2 | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Variables | Total N = 3034 | Compliant N = 1562 | Non-compliant N = 1472 | Univariate analysis | Multivariate analysis | Total N = 293 | Compliant N = 237 | Non-compliant N = 56 | Univariate analysis | Multivariate analysis | ||||||||
| OR | 95 % CI | p | aOR | 95 % CI | p | OR | 95 % CI | p | aOR | 95 % CI | p | |||||||
| Sex ratio | 1.16 | 1.21 | 1.11 | 0.50 | 1 | 1.1 | 0.8 | 0.34 | ||||||||||
| Age | ||||||||||||||||||
| Median yrs [IQR] | 3 [1.4–5] | 3.4 [2–5.4] | 2.3 [1–4.5] | 0.2 | 0.1–0.3 | <0.001* | 3.6 [1.9–5.7] | 3.4 [1.7–5.1] | 4.5 [2.9–7.8] | 1.1 | 1.01–1.2 | 0.008 | 1.2 | 1–1.3 | 0.007** | |||
| 10.7 | 5.7–20.1 | |||||||||||||||||
| Age <1 year (%) | 16.6 | 8.3 | 24.4 | 3.7 | 3–4.7 | <0.001 | 3 | 2.4–3.9 | <0.001 | 14 | 14.7 | 10.7 | 1 | - | - | |||
| Age >1 year (%) | 83.4 | 91.7 | 74.6 | 1 | - | - | 1 | - | - | 86 | 85.3 | 89.3 | 1.4 | 0.6–3.6 | 0.44 | |||
| Severity signs | ||||||||||||||||||
| Respiratory distress (%) | 28.5 | 20.5 | 36.5 | 2.3 | 1.9–2.7 | <0.001 | 1 | 0.8–1.3 | 0.71 | 26.7 | 27.4 | 23.6 | 0.8 | 0.4–1.6 | 0.56 | |||
| Ill appearance (%) | 31.3 | 22.1 | 39.9 | 2.5 | 2.1–2.9 | <0.001 | 1.3 | 1.1–1.6 | 0.01 | 28.7 | 27.7 | 32.7 | 1.3 | 0.7–2.4 | 0.46 | |||
| Risk factors for pneumococcal infectiona (%) | 5.7 | 3.5 | 8.1 | 2.4 | 1.8–3.5 | <0.001 | 1.4 | 0.95–2.1 | 0.09 | 6.8 | 3.4 | 21.4 | 7.8 | 2.9–21.1 | <0.001 | 4.1 | 1.3–12.7 | 0.02 |
| Centres (%) | ||||||||||||||||||
| Centre 1 | 5.4 | 53.6 | 46.4 | 1 | - | - | 1 | - | - | |||||||||
| Centre 2 | 12.4 | 60.6 | 39.4 | 0.8 | 0.5–1.1 | 0.13 | 0.9 | 0.5–1.3 | 0.37 | 34 | 85 | 15 | 1 | - | - | 1 | - | - |
| Centre 3 | 20.5 | 48.8 | 51.2 | 1.2 | 0.9–1.7 | 0.27 | 1.2 | 0.8–1.8 | 0.48 | 32 | 87 | 13 | 2.4 | 1.2–4.9 | 0.01 | 1.3 | 0.6–3.1 | 0.53 |
| Centre 4 | 13.1 | 36.6 | 63.4 | 2 | 1.4–2.9 | <0.001 | 2 | 1.3–3 | 0.002 | |||||||||
| Centre 5 | 4.8 | 22,1 | 77.9 | 4.1 | 2.4–6.9 | <0.001 | 1.7 | 0.9–3.1 | 0.06 | |||||||||
| Centre 6 | 12.3 | 65.5 | 34.5 | 0.6 | 0.4–0.9 | 0.009 | 0.6 | 0.4–0.9 | 0.02 | |||||||||
| Centre 7 | 9.6 | 47.8 | 52.2 | 1.3 | 0.9–1.9 | 0.23 | 0.9 | 0.6–1.5 | 0.79 | 34 | 70 | 30 | 0.8 | 0.4–1.9 | 0.68 | 0.6 | 0.2–1.5 | 0.19 |
| Centre 8 | 0.6 | 47.1 | 52.2 | 1.3 | 0.5–3.5 | 0.61 | 0.7 | 0.2–2.5 | 0.61 | |||||||||
| Centre 9 | 17.8 | 63.5 | 36.5 | 0.7 | 0.5–0.9 | 0.02 | 0.7 | 0.5–1.1 | 0.17 | |||||||||
| Centre 10 | 3.4 | 25.2 | 74.8 | 3.4 | 2–6 | <0.001 | 1.9 | 1–3.6 | 0.05 | |||||||||
| Season | ||||||||||||||||||
| Winter | 25.3 | 25.3 | 25.2 | 1 | - | - | 1 | 78.5 | 76.4 | 87.5 | 1 | - | 1 | - | - | |||
| Spring | 17 | 18.4 | 15.6 | 0.7 | 0.6–0.9 | 0.01 | 0.7 | 0.5–0.9 | 0.012 | 21.5 | 23.6 | 12.5 | 0.5 | 0.2–1.1 | 0.07 | 0.5 | 0.2–1.4 | 0.18 |
| Summer | 15 | 15.4 | 14.7 | 0.8 | 0.7–1.6 | 0.15 | 0.8 | 0.6–1.1 | 0.25 | - | - | - | - | - | - | |||
| Fall | 42.6 | 42.4 | 42.7 | 0.9 | 0.7–1.1 | 0.19 | 0.9 | 0.8–1.1 | 0.7 | - | - | - | - | - | - | |||
| Biologyb (%) | ||||||||||||||||||
| Leucocytes ≥10,000/mm3 | 74.2 | 76.2 | 73.5 | 0.9 | 0.6–1.1 | 0.26 | 68.9 | 72.9 | 61.1 | 0.6 | 0.2–1.4 | 0.21 | ||||||
| CRP ≥40 mg/L | 53.9 | 55.6 | 53.8 | 0.9 | 0.7–1.1 | 0.18 | 55.2 | 55.8 | 54.1 | 0.9 | 0.4–2.1 | 0.86 | ||||||
| PCT ≥2 mg/mL | 44.7 | 50 | 43.7 | 0.9 | 0.5–1.4 | 0.58 | 36.4 | 38.4 | 33.3 | 0.8 | 0.2–2.9 | 0.73 | ||||||
| Positive blood culture | 3.6 | 3.2 | 3.8 | 1.2 | 0.5–2.8 | 0.71 | 4.9 | 2.9 | 7.7 | 3.2 | 0.3–39.6 | 0.33 | ||||||
| Prescriber (%) | ||||||||||||||||||
| Resident | 53.4 | 44.4 | 55.5 | 1 | - | - | 1 | - | - | |||||||||
| Fellow | 21.2 | 22.3 | 16.7 | 0.9 | 0.4–2.2 | 0.87 | 0.6 | 0.2–1.5 | 0.29 | |||||||||
| Senior | 25.4 | 22.3 | 38.9 | 2.2 | 1.4–4.3 | 0.02 | 1.7 | 0.8–3.5 | 0.19 | |||||||||
| Hospitalization (%) | 32.2 | 12.4 | 51.9 | 7.6 | 6.2–9.2 | <0.001 | 5.7 | 4.6–7.2 | <0.001 | 26.7 | 22 | 46.3 | 3.1 | 1.6–5.7 | <0.001 | 4.1 | 2–8.4 | <0.001 |
| PICU | 6.2 | 7.3 | 5.7 | 3.8 | 1.9 | 7.7 | ||||||||||||
| Outcome (%) | ||||||||||||||||||
| Apyrexia at 48 hc | 89.8 | 90 | 89.6 | 0.9 | 0.7–1.3 | 0.77 | 81.7 | 83.1 | 78.1 | 0.7 | 0.3–2 | 0.53 | ||||||
| Death | 0.2 | 0.2 | 0.2 | 1 | 0.2–5.3 | 0.9 | 0.7 | 0.8 | 0 | |||||||||
Table 1 legend: OR odds ratio, aOR adjusted odds ratio, 95%CI 95 % confidence interval, IQR interquartile range, PICU Paediatric Intensive Care Unit
*age was non-linear in period 1 and was transformed to a second degree polynomial as follows: x1 = ln(X) − 0.3 and x 2 = X0,5 − 1.2 (where: X = age/1000) in the univariate analysis, age was entered as a dichotomous variable (around 1 year) in the multivariate analysis
**age was normally distributed in period 2 and was entered as a continuous variable in the multivariate analysis
arisk factors for pneumococcal infection were reported for 2992 children during period 1
bin period 1, white blood cell counts (WBC) were done for 1228 children, C-reactive protein (CRP) for 1394, procalcitonin (PCT) for 396, and blood cultures for 838 children; in period 2, WBC was done for 106 children, CRP for 114, and PCT for 44
capyrexia occurring at 48 h was reported for 1640 children during period 1 and 115 children during period 2