[Diagnosis and therapeutic strategies in pneumonia in childhood]

Acute lower respiratory tract infections remain a major cause of morbidity in infants and children. In the majority of patients therapy is complicated by difficulties in securing a specific diagnosis and identification of the causative organism. Treatment is therefore largely based on experiential rather than experimental data. In our study we have tried in 722 patients with pneumonia to correlate the clinical findings with the causative agents. Age and a careful medical history give good clues towards the most probable aetiologic agent. Additional information is gained by the course of the illness. Physical examination, chest X-ray and few limited laboratory tests can also be of help to identify the most likely organism. Once the organism is identified, appropriate antimicrobial agent can be started. It is not only the choice of the antimicrobial substance, but also the choice of the proper total daily dose, dosage interval and mode of administration. By this management we had good results also in elimination of problem organism such as pseudomonas in CF.