Abstract
BackgroundCommunity-acquired pneumonia (CAP) is a leading cause of morbidity and mortality globally, responsible for more than 14% of deaths in children younger than 5 years of age. Due to difficulties with pathogen identification and diagnostics of CAP in children, targeted antimicrobial therapy is not possible, hence the widespread use of empirical antibiotics, in particular penicillins, cephalosporin, and macrolides. ObjectivesThis review aimed to address medical, societal, and political issues associated with the widespread use of empirical antibiotics for CAP in the United Kingdom, India, and Nigeria. MethodsA literature review was performed identifying the challenges pertaining to the use of widespread empirical antibiotics for CAP in children. A qualitative analysis of included studies identified relevant themes. Empirical guidance was based on guidelines from the World Health Organization, British Thoracic Society, and Infectious Diseases Society of America, used in both industrialized and resource-poor settings. ResultsIn the United Kingdom there was poor adherence to antibiotics guidelines. There was developing antibiotic resistance to penicillins and macrolides in both developing and industrialized regions. There were difficulties accessing the care and treatment when needed in Nigeria. Prevention strategies with vaccination against Streptococcus pneumonia, Haemophilus influenza, and measles are particularly important in these regions. ConclusionsEffective and timely treatment is required for CAP and empirical antibiotics are evidence-based and appropriate in most settings. However, better diagnostics and education to target treatment may help to prevent antibiotic resistance. Ensuring the secure financing of clean food and water, sanitation, and public health infrastructure are also required to reduce the burden of disease in children in developing countries.
Highlights
In 2016, community-acquired pneumonia (CAP) remained an important cause of morbidity and mortality in both industrialized and developing countries.[1]
A literature search was performed to address the hypothesis that the challenges with widespread empirical antibiotic use for children with Community-acquired pneumonia (CAP) are diverse in the United Kingdom, India, and Nigeria
Exclusion criteria included studies of CAP in adults, complicated pneumonia; CAP occurring in regions outside of the United Kingdom, India, or Nigeria; and studies not relating to pneumonia
Summary
In 2016, community-acquired pneumonia (CAP) remained an important cause of morbidity and mortality in both industrialized and developing countries.[1] Between 2000 and 2010, pneumonia caused 14.1% (n 1⁄4 1,071,000) of all deaths worldwide in children aged 1 month to 5 years, making it the single most significant disease.[2] There are many factors that influence CAP incidence and disproportionately affect children in developing countries, including access to health care, vaccine implementation, living n Address correspondence to: Charlene M. Due to difficulties with pathogen identification and diagnostics of CAP in children, targeted antimicrobial therapy is not possible, the widespread use of empirical antibiotics, in particular penicillins, cephalosporin, and macrolides. Objectives: This review aimed to address medical, societal, and political issues associated with the widespread use of empirical antibiotics for CAP in the United Kingdom, India, and Nigeria. Ensuring the secure financing of clean food and water, sanitation, and public health infrastructure are required to reduce the burden of disease in children in developing countries
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