Introduction: Community-acquired pneumonia (CAP) is one of the leading causes of hospitalization in children. The duration of hospitalization depends on several factors including well-being of the child, improvement of vital signs, need for parenteral fluid and antibiotics, and the development of complications. Medical clowns (MCs) are known to assist in reducing pain and alleviating anxiety and have been gradually integrated into many aspects of hospital treatment routine nowadays. Aim: To evaluate the effect of MC intervention on length of hospitalization in children admitted with CAP.

Methods: A prospective randomized controlled trial allocated 52 children (2-18 years) hospitalized for CAP to receive standard care alone (control group, n=25) or standard care plus 15-minute MC visits twice daily during the first 48 hours of hospitalization (intervention group, n=26). The primary outcome was hospitalization duration. Secondary outcomes included intravenous (IV) antibiotic duration, change in well-being scores, complications, and inflammatory markers. 

Results: The two groups were comparable in all demographic characteristics with a mean age of 4.4±3.6 years. The intervention group had shorter duration of hospitalization (43.5 vs 70 hours, p=0.03) and IV antibiotic treatment duration (2.3 vs 5 days, p<0.01) compared to controls. There were no intergroup differences in chest tube insertion rates, well-being scores, or most inflammatory markers.

Conclusions: The integration of MC into the pediatric CAP care-team reduced length of hospitalization and need of IV antibiotics. This can improve the quality of care as well as the burden and cost endured by hospitalization with CAP.