New database transforms evidence-based care for children with lower respiratory tract infections

Lower respiratory tract infections (LRTIs) remain the most common illnesses in children, accounting for up to two-thirds of pediatric outpatient and inpatient cases in China. Despite their high prevalence, there has been a lack of large-scale, real-world data to guide the clinical management of pneumonia, acute bronchitis, and related conditions in Chinese children. Existing international databases often focus on adults, single centers, or specific pathogens, limiting their applicability to pediatric populations. Reliable evidence on treatment outcomes and rational drug use is therefore urgently needed. Due to these challenges, comprehensive studies on the efficacy of different treatment modalities for pediatric LRTIs are required.

Researchers from the Children's Hospital of Chongqing Medical University and Shanghai Children's Hospital, led by Professors Enmei Liu and Quan Lu, have established China's first national multicenter database on the "efficacy of different treatment modalities for lower respiratory tract infections in children." The study (DOI: 10.1002/pdi3.79), published in Pediatric Discovery in July 2025, collected clinical data from 36 hospitals across 12 provinces. The database integrates demographic, clinical, and therapeutic information to support evidence-based management of childhood pneumonia, bronchitis, and other LRTIs under real-world conditions.

The registry includes 4,805 pediatric patients aged 0-14 years, with pneumonia (72.4%) and acute bronchitis (20.7%) identified as the most common LRTIs. The average patient age was 3.26 years, and boys accounted for 59% of cases. Clinical data were collected through standardized on-site visits and patient-reported outcomes at days 0, 7, 14, and 28, capturing treatment responses, symptom relief, and adverse events.Analyses revealed that symptom severity scores decreased significantly within one week of treatment, and over 82% of patients achieved clinical improvement. The database also records diverse therapeutic approaches, including pathogen-specific therapy (79%), symptomatic treatment (90%), and the use of traditional Chinese medicine (33%). Only 0.3% of patients experienced mild or moderate adverse drug reactions, confirming the overall safety of current regimens.Compared with earlier single-center or disease-specific studies, this national platform offers a more holistic view of pediatric respiratory infections in China, bridging the gap between clinical practice and big data analytics. It allows physicians to compare treatment outcomes across regions and supports large-scale epidemiological and pharmacological research.

Our goal was to create a robust and transparent data resource that reflects real-world pediatric care across China. By integrating data from diverse hospitals, this database enables clinicians to better understand disease patterns, assess treatment effectiveness, and optimize the use of antibiotics and supportive therapies. It also provides a model for building national health data networks in other fields, ultimately advancing precision medicine and improving outcomes for children with respiratory diseases."

Prof. Enmei Liu, corresponding author of the study

The establishment of this database marks a milestone in pediatric clinical informatics in China. It facilitates cross-regional collaboration, supports rational drug evaluation, and provides the foundation for future real-world studies on respiratory infections and related complications. The research team plans to expand the database's scope by incorporating post-COVID-19 data and developing intelligent analytics tools to predict disease progression and treatment response. By bridging clinical practice with big-data science, this initiative paves the way for more personalized, efficient, and evidence-based care for children affected by lower respiratory tract infections.