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Murine Oropharyngeal Aspiration Model of Ventilator-associated and Hospital-acquired Bacterial Pneumonia
Published on: June 28, 2018
Clinical management of community-acquired pneumonia in young children
Amanda C Nascimento-Carvalho1, Cristiana M Nascimento-Carvalho2
1a Bahiana School of Medicine , Bahiana Foundation for Science Development , Salvador , Brazil.
Insights
Community-acquired pneumonia (CAP) in children under five is a major global health concern. Penicillins are recommended as the first-line antibiotic treatment for childhood CAP, balancing efficacy and safety in empirical therapy.
Area of Science:
- Pediatric infectious diseases
- Pharmacology and therapeutics
- Public health and epidemiology
Background:
- Community-acquired pneumonia (CAP) is a leading cause of mortality in children globally.
- Empirical antibiotic therapy choices for childhood CAP are subject to ongoing debate.
Purpose of the Study:
- To provide an updated overview of chemical management recommendations for childhood CAP.
- To discuss current evidence for rational antibiotic use in young children with CAP.
Main Methods:
- MEDLINE literature search using keywords: 'guidelines,' 'community-acquired pneumonia,' and 'children.'
- Inclusion of English articles with consensual recommendations for children aged 2 months to 5 years without HIV.
- Review of the latest evidence guiding antibiotic selection.
Main Results:
- First-line antibiotics for ambulatory CAP: amoxicillin (50 mg/kg/day).
- First-line antibiotics for hospitalized CAP: aqueous penicillin G or ampicillin.
- Ceftriaxone for severe cases; oxacillin or macrolides for specific pathogens (S. aureus, atypical bacteria).
Conclusions:
- Penicillins are confirmed as the primary antibiotic choice for treating CAP in young children.
- Updated recommendations aim to guide effective empirical treatment strategies.
- Rational antibiotic use is emphasized for managing childhood CAP.
Introduction:
Community-acquired pneumonia (CAP) is the leading cause of mortality among children under 5 years worldwide. However, the choices of chemical therapy for the empirical treatment of CAP are frequently debated.
Areas Covered:
The authors provide an update on the chemical management recommendations for childhood CAP. The authors have performed a MEDLINE literature search, using the keywords 'guidelines,' 'community-acquired pneumonia,' AND 'children.' Articles published in English, providing consensual recommendations on management of children >2 months and <5 years with CAP but without HIV infection, were included. Furthermore, the authors discuss the latest evidence guiding the rational use of antibiotics in young children with CAP.
Expert Opinion:
For the chemical management of CAP, the first-line antibiotic options are amoxicillin (50 mg/kg/day, every 12 h) among ambulatory patients and aqueous penicillin G (200,000 IU/kg/day, every 6 h) or ampicillin (200 mg/kg/day, every 6 h) for hospitalized children. Ceftriaxone can be considered in the treatment of very severe cases. Oxacillin or macrolide may be added in specific situations, if Staphylococcus aureus or atypical bacteria, respectively, are potential etiological agents, although not deemed common. Penicillins remain the first-line choice of antibiotic for the treatment of CAP in young children.
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