Abstract
Community-acquired pneumonia (CAP) is a leading cause of hospitalization in children. The hospitalization duration depends on factors as child's well-being, vital signs, need for parenteral treatments, and development of complications. Medical clowns (MCs) are known to assist in reducing pain and alleviating anxiety and have been integrated into many aspects of hospital treatment routines. Our aim was to evaluate the effect of MC intervention on length of hospitalization in children admitted with CAP. A prospective quasi-randomized controlled trial allocated 51 children (2-18 years) hospitalized for CAP to receive standard care (control group, n = 25) or standard care plus 15-minute MC visits twice daily during the first 48 h of hospitalization (intervention group, n = 26). The primary outcome was hospitalization duration. Both groups were comparable in all demographic and clinical characteristics at admission with a mean age of 4.4 ± 3.6 years. The intervention group had significantly shorter duration of hospitalization (43.5 vs. 70 h, p = 0.03) and IV antibiotic treatment duration (48 vs. 72 h, p < 0.01) compared to controls. When comparing day 1 to day 2 in each group, significant decreases in respiratory rate, heart rate, white blood cell count, and absolute neutrophil count were noted in the study group. No significant differences were observed between the two groups in changes in patient well-being. The integration of MC into the pediatric CAP care-team reduced length of hospitalization and need for IV antibiotics. This can improve the quality of care as well as the burden and cost endured by hospitalization with CAP. Future larger studies are warranted to support these positive effects of MC.Trial registration ClinicalTrials.gov Identifier NCT06750029, 27/12/2024.