Susanna Esposito1, Nicola Principi. 1. Department of Maternal and Pediatric Sciences, Università degli Studi di Milano, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy. susanna.esposito@unimi.it
Abstract
PURPOSE OF REVIEW: This review discusses unsolved problems concerning pediatric community-acquired pneumonia (CAP) and identifies the areas of research that need to be developed. RECENT FINDINGS: Diagnosing pediatric CAP and the required hospitalization are difficult problems especially in the presence of mild signs and symptoms. It is frequently not possible to identify the cause of this disease, and this explains why antibiotics are unnecessarily prescribed in some cases. The treatment recommendations for severe CAP are better defined than those for mild and moderate CAP. SUMMARY: It is possible to prepare recommendations for most of the problems that emerge in severe cases of pediatric CAP even though its cause can also be difficult to identify. However, the recommended approach to mild or moderate cases is always based on mainly moderate or poor quality evidence. There is an urgent need for further studies aimed at defining first-line and second-line antibiotic therapy for mild and moderate CAP. In the absence of new data, it is necessary to be aware that a substantial number of patients will not be optimally treated.
PURPOSE OF REVIEW: This review discusses unsolved problems concerning pediatric community-acquired pneumonia (CAP) and identifies the areas of research that need to be developed. RECENT FINDINGS: Diagnosing pediatric CAP and the required hospitalization are difficult problems especially in the presence of mild signs and symptoms. It is frequently not possible to identify the cause of this disease, and this explains why antibiotics are unnecessarily prescribed in some cases. The treatment recommendations for severe CAP are better defined than those for mild and moderate CAP. SUMMARY: It is possible to prepare recommendations for most of the problems that emerge in severe cases of pediatric CAP even though its cause can also be difficult to identify. However, the recommended approach to mild or moderate cases is always based on mainly moderate or poor quality evidence. There is an urgent need for further studies aimed at defining first-line and second-line antibiotic therapy for mild and moderate CAP. In the absence of new data, it is necessary to be aware that a substantial number of patients will not be optimally treated.
Authors: Susanna Esposito; Maria Di Gangi; Fabio Cardinale; Eugenio Baraldi; Ilaria Corsini; Liviana Da Dalt; Pier Angelo Tovo; Antonio Correra; Alberto Villani; Oliviero Sacco; Laura Tenero; Piera Dones; Monia Gambino; Alberto Zampiero; Nicola Principi Journal: PLoS One Date: 2016-11-15 Impact factor: 3.240