Antibiotic therapy for pediatric community-acquired pneumonia: Do we know when, what and for how long to treat?

Susanna Esposito, Robert Cohen, Javier Diez Domingo, Oana Falup Pecurariu, David Greenberg, Ulrich Heininger, Markus Knuf, Irja Lutsar, Nicola Principi, Fernanda Rodrigues, Mike Sharland, Vana Spoulou, George A. Syrogiannopoulos, Vytautas Usonis, Anne Vergison, Urs B. Schaad

Research output: Contribution to journalReview articlepeer-review

82 Scopus citations

Abstract

Community-acquired pneumonia (CAP) is a common cause of morbidity among children in developed countries and accounts for an incidence of 10-40 cases per 1000 children in the first 5 years of life. Given the clinical, social and economic importance of CAP, there is general agreement that prompt and adequate therapy is essential to reduce the impact of the disease. The aim of this discussion paper is to consider critically the available data concerning the treatment of uncomplicated pediatric CAP and to consider when, how and for how long it should be treated. This review has identified the various reasons that make it difficult to establish a rational approach to the treatment of pediatric CAP, including the definition of CAP, the absence of a pediatric CAP severity score, the difficulty of identifying the etiology, limited pharmacokinetic (PK)/pharmacodynamic (PD) studies, the high resistance of the most frequent respiratory pathogens to the most widely used anti-infectious agents and the lack of information concerning the changes in CAP epidemiology following the introduction of new vaccines against respiratory pathogens. More research is clearly required in various areas, such as the etiology of CAP and the reasons for its complications, the better definition of first-and second-line antibiotic therapies (including the doses and duration of parenteral and oral antibiotic treatment), the role of antiviral treatment and on how to follow-up patients with CAP. Finally, further efforts are needed to increase vaccination coverage against respiratory pathogens and to conduct prospective studies of their impact.

Original languageEnglish
Pages (from-to)e78-e85
JournalPediatric Infectious Disease Journal
Volume31
Issue number6
DOIs
StatePublished - 1 Jun 2012
Externally publishedYes

Keywords

  • Antibiotics
  • Antimicrobial treatment
  • Community-acquired pneumonia
  • Pneumonia
  • Respiratory infection

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