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Published on: February 23, 2014
Community acquired paediatric pneumonia; experience from a pneumococcal vaccine- naive population
Sanath Thushara Kudagammana1, Ruchira Ruwanthika Karunaratne1, Thilini Surenika Munasinghe1
1Department of Paediatrics, Faculty of Medicine, University of Peradeniya, Peradeniya, 20400 Sri Lanka.
Insights
Childhood community-acquired pneumonia caused significant illness in children but no deaths. Many required second-line antibiotics, suggesting potential antibiotic resistance in Sri Lanka.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Childhood pneumonia remains a major cause of mortality globally, particularly in South-East Asia and Africa.
- Pneumonia accounted for 16% of global under-five deaths in 2015, with nearly one million fatalities.
- Sri Lanka reported 21,000 pneumonia cases in 2006, with 40% affecting children under four.
Purpose of the Study:
- To analyze the clinical characteristics, management, and outcomes of community-acquired pneumonia in children.
- To assess the morbidity and mortality associated with pediatric pneumonia in the studied population.
Main Methods:
- A retrospective study was conducted on children aged 1 month to 14 years admitted with community-acquired pneumonia.
- Data were collected from patient records between March 2016 and July 2017.
Main Results:
- Bronchopneumonia was diagnosed in 48% of the 127 patients.
- Two-thirds of patients required second-line intravenous antibiotics.
- 51% of patients needed high-dependency unit care with supplemental oxygen; no mortality was observed.
Conclusions:
- Community-acquired pediatric pneumonia is associated with significant morbidity but not mortality in this population.
- The high need for second-line antibiotics suggests potential antibiotic resistance.
- Implementing a national antibiotic policy is recommended to address this issue.
Background:
Childhood pneumonia continues to be a disease that causes severe morbidity and mortality among children mainly in South-East Asia and Africa though it is not so in the developed world. Pneumonia accounts for 16% of all deaths of children under 5 years old in the world, killing nearly one million children in 2015. In Sri Lanka, there were 21,000 reported cases of pneumonia in 2006, 40% were in the age group of less than 4 years.
Methods:
This was a retrospective study done on the children aged 1 month to 14 years who were admitted to the Professorial Paediatric unit of Teaching Hospital, Peradeniya between 1st of March 2016 and 30th of July 2017 fulfilling diagnostic criteria for community-acquired pneumonia. Data including diagnosis, clinical details, management details and other relevant data were collected from patient records by using a data collection sheet.
Results:
In this study, 48% of 127 patients admitted with community-acquired pneumonia had bronchopneumonia. About 2/3 of the patients neededa secondline of intravenous antibiotics while 51/ 127 needed care in the high dependency unit with supplemental oxygen. No mortality was observed in the group.
Conclusions:
Community- acquired paediatric pneumonia has a significant associated morbidity but not mortality in the studied population. The need for the second-line treatment with intravenous antibiotics in a significant proportion of patients may indicate a high degree of antibiotic resistance. Introduction of national antibiotic policy will help the cause.
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