Background

Aspiration is a significant cause of respiratory morbidity in children. It can be difficult to diagnose, often with no clinical symptoms except persistent or recurrent cough. This results in significant Emergency Care attendance and antibiotic use by the patient, and/or lung damage.

Methods

A service review was carried out between the Leeds Children?s Hospital Respiratory team and the Leeds Community Hospital Speech and Language Team (SALT), looking specifically at the length of time to referral, underlying diagnoses and use of antibiotics. This was a retrospective notes based analysis comparing data from two electronic patient records.

Results

Sixty one patients looked after by both the SALT and respiratory team were identified. The average age at diagnosis of aspiration was 30.5 months. Fifty two patients had an underlying comorbidity. Two thirds had been referred to respiratory before SALT. Thirty eight (62%) patients had more than 5 courses of antibiotics. Fourteen (23%) had attended the emergency department more than 6 times. There was no difference between antibiotic use of those children with comorbidities and those without (average of 9.2 vs 10.9 courses respectively), nor whether the underlying conditions were neurological in origin or not (9.4 vs 9.5 courses respectively).

Conclusions

Children who aspirate have a considerable respiratory burden with respect to antibiotic use and emergency care provision. Some of these children would develop aspiration over time due to their underlying condition. An early recognition and diagnosis of aspiration may reduce antibiotic burden in children who aspirate.