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Defining the aetiology of paediatric community-acquired pneumonia: an unsolved problem

Susanna Esposito1, Nicola Principi2

  • 1a Pediatric Clinic, Department of Surgical and Biomedical Sciences , Università degli Studi di Perugia , Perugia , Italy.

Expert Review of Respiratory Medicine
|January 4, 2019
PubMed

Insights

Pediatric community-acquired pneumonia (CAP) is a global health issue. Current treatment relies on pathogen probability, but new tests could reduce unnecessary antibiotic use and combat resistance.

Area of Science:

  • Pediatric infectious diseases
  • Respiratory medicine
  • Clinical microbiology

Background:

  • Pediatric community-acquired pneumonia (CAP) is a significant worldwide health concern.
  • Current etiological knowledge of CAP is limited, leading to probability-based treatment decisions.
  • Over-reliance on antibiotics for pediatric CAP contributes to resistance and adverse events.

Purpose of the Study:

  • To review current knowledge on the etiology of pediatric CAP.
  • To discuss limitations in etiological studies for pediatric CAP.
  • To explore diagnostic tests for differentiating viral from bacterial infections in pediatric CAP.

Main Methods:

  • This is a narrative review.
  • The review synthesizes existing literature on pediatric CAP etiology.
  • It examines diagnostic approaches and their limitations.

Main Results:

  • Therapeutic decisions for pediatric CAP are based on the likelihood of bacterial infection and common pathogens.
  • Antibiotic overuse is prevalent due to fear of untreated bacterial CAP, despite being unnecessary in many cases.
  • Biomarker-based point-of-care tests could significantly decrease antibiotic prescriptions.

Conclusions:

  • Accurate differentiation of viral versus bacterial CAP is crucial for appropriate treatment.
  • Reducing unnecessary antibiotic use in pediatric CAP is essential to mitigate resistance and adverse effects.
  • Development and implementation of point-of-care diagnostic tests are key to improving pediatric CAP management.
Abstract

Keywords:
Community-acquired pneumonia

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