Childhood community-acquired pneumonia

Abstract

Much of what we know about childhood community-acquired pneumonia in developed countries comes from studies in Europe, where approximately 2.5 million cases of childhood pneumonia occur yearly. Streptococcus pneumoniae, Mycoplasma pneumoniae, and respiratory syncytial virus are the most common causative agents. Blood culture is seldom positive and mortality is very low in developed countries. Tachypnea and crackles on auscultation are the major findings suggesting pneumonia, but their sensitivity and specificity are not high enough, and, if possible, a radiograph of the chest should be obtained to confirm the diagnosis. Recommendations for antibiotic treatment vary. Based on the etiologic studies we suggest macrolides as the first choice in outpatients and depending on the clinical picture and severity of the illness penicillin G, macrolide, or cefuroxime plus macrolide in hospitalized patients. The recovery of children with pneumonia is usually rapid and in uncomplicated cases routine follow-up radiographs and check-ups are unnecessary.