Pneumonia: antimicrobial therapy for infants and children

Pneumonia in infancy and childhood presents the practitioner with the frustrating problem of a disease that is self-limited in the majority but poses a real threat to the minority. Existing diagnostic methods are inadequate and are likely to remain so in the foreseeable future. In the absence of specific etiologic information, physicians must make decisions about use of antimicrobial therapy based only on probabilities that are themselves derived from less than perfect studies. It is the thesis of this review that, when confronted with a baby with pneumonia, the physician should perform a limited number of diagnostic tests and prescribe antimicrobial therapy. Choice of antimicrobial therapy is usually most heavily influenced by the age of the patient and only to a lesser extent by clinical presentation or results of laboratory tests.