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Community-acquired pneumonia in the post 13-valent pneumococcal conjugate vaccine era
Erin E Shaughnessy1, Erika L Stalets, Samir S Shah
1aDivision of Hospital Medicine bDivision of Critical Care cDivision of Infectious Disease, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Insights
Pediatric community-acquired pneumonia (CAP) management has evolved since the 2010 vaccine introduction. Current guidelines focus on office-based diagnosis and treatment, noting shifts in causative microbes like increased Mycoplasma pneumoniae in older children.
Area of Science:
- Pediatric infectious diseases
- Vaccinology
- Microbiology
Background:
- The 13-valent pneumococcal conjugate vaccine (PCV13) was introduced in 2010, significantly impacting pediatric infectious disease epidemiology.
- Community-acquired pneumonia (CAP) remains a common childhood illness, with evolving etiological patterns.
Purpose of the Study:
- To review the outpatient management of pediatric CAP.
- To discuss the changing microbiology of CAP post-PCV13 introduction.
- To provide an overview of current national guideline recommendations for diagnosis and treatment.
Main Methods:
- Literature review focusing on pediatric CAP management.
- Analysis of microbiological trends since 2010.
- Synthesis of national guideline recommendations.
Main Results:
- Widespread PCV13 immunization has led to decreased rates of invasive pneumococcal disease and antibiotic resistance.
- Viral pathogens are the primary cause of CAP in young children.
- Children over five years old exhibit higher incidence rates of Mycoplasma pneumoniae infections.
- A recent national guideline provides updated recommendations for pediatric CAP evaluation and treatment in outpatient settings.
Conclusions:
- Office-based practitioners should be aware of the shifting microbiology of pediatric CAP.
- Current guidelines offer practical approaches to the diagnosis and treatment of CAP in infants and children.
- Vaccination strategies continue to influence the epidemiology of pediatric respiratory infections.
Purpose Of Review:
This review covers the outpatient management of pediatric community-acquired pneumonia (CAP), discussing the changing microbiology of CAP since the introduction of the 13-valent pneumococcal conjugate vaccine in 2010, and providing an overview of national guideline recommendations for diagnostic evaluation and treatment.
Recent Findings:
Rates of invasive pneumococcal disease and pneumococcal antibiotic resistance have plummeted since widespread 13-valent pneumococcal conjugate vaccine immunization. Viruses remain the most common cause of CAP in young children; children over age 5 years have increased rates of Mycoplasma pneumoniae. A recent national guideline offers recommendations for office-based diagnostic evaluation and treatment of pediatric CAP.
Summary:
This review offers a discussion of the above findings with practical recommendations for the office-based practitioner in the evaluation and treatment of an infant (>3 months) or child with suspected CAP.
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