Antibiotics for bacterial pneumonia in children

Abstract

Pneumonia remains the leading cause of mortality in children. Diagnosis depends on a combination of factors, including clinical assessment, radiological and laboratory findings. Although Streptococcus pneumoniae remains the most important cause of childhood bacterial pneumonia, the great majority of cases of community-acquired pneumonia (CAP) are of viral etiology. A new, rapid, and inexpensive test that differentiates viral from bacterial pneumonia is needed to decide empiric antibiotic treatment. Antibiotics effective against the expected bacterial pathogens should be instituted where necessary. The role of emerging pathogens and the effect of pneumococcal resistance and heptavalent conjugate pneumococcal vaccines are to be considered in practice. There are reports supporting the valid and highly efficacious use of penicillin as a first-line drug for treating CAP. This review raises the issue of the overuse of unnecessary antibiotics in viral CAPs and the use of second or third-line antibiotics for non-complicated pneumonias in most clinical settings.