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Complications in community acquired pneumonia: magnitude of problem, risk factors, and management in pediatric age
Susanna Esposito1, Giulia Dal Canto1, Maria Rosaria Caramia1
1Pediatric Clinic, Pietro Barilla Children's Hospital, University of Parma, Parma, Italy.
Insights
Complicated community-acquired pneumonia (CAP) in children remains a challenge. Improved diagnostic tools like lung ultrasonography (US) and updated treatment guidelines are crucial for better management and outcomes.
Area of Science:
- Pediatric Infectious Diseases
- Pulmonology
Background:
- Vaccinations and new antibiotics have reduced overall community-acquired pneumonia (CAP) incidence and improved prognosis in children.
- Despite advances, complicated CAP continues to pose a significant health burden globally.
Purpose of the Study:
- To evaluate the burden of complicated CAP in pediatric patients.
- To discuss optimal management strategies for complicated pediatric CAP.
Main Methods:
- Review of current literature on pediatric complicated CAP.
- Analysis of diagnostic and therapeutic approaches.
Main Results:
- Complicated CAP presents a persistent challenge in both developed and developing nations.
- Lung ultrasonography (US) shows promise for earlier identification of high-risk cases.
Conclusions:
- Effective antibiotic therapy for all CAP cases, especially complicated ones, remains a challenge.
- Developing consensus guidelines for corticosteroids, fibrinolytic agents, and surgical interventions is essential for improving management.
Introduction:
In the last decades, the large use of several effective vaccines has dramatically reduced the incidence of community acquired pneumonia (CAP) in infants and children. Moreover, the availability of new antibiotics effective against emerging resistant strains of bacteria has greatly improved the early and long-term prognosis of this disease.
Areas Covered:
The aim of this manuscript is to evaluate the burden of complicated CAP in pediatric age and to discuss its appropriate management.
Expert Opinion:
Complicated CAP remains a problem for children in industrialized and developing countries. A larger use of lung ultrasonography (US) as first diagnostic approach could significantly improve early identification of cases at higher risk of complications. Difficult to solve, is the problem of the use of an antibiotic therapy able to assure adequate control in all the CAP cases, including those at high risk of or with already established complications. All these findings reveal that control of the incidence of complicated CAP remains difficult and will not be significantly changed in the next few years. Any attempt to improve complicated CAP management must be made. Consensus documents on better definition of the use of corticosteroids, fibrinolytic agents, and interventional procedures (including surgery) can allow us to reach this goal.
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