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Paediatric Pulmonology and Allergology
2005 April, Vol. VIII, No. 1 (2653-2658)
EUROPEAN PERSPECTIVE: COMMUNITY-ACQUIRED PNEUMONIA IN CHILDREN
Matti Korppi*, Arunas Valiulis**
* Kuopio University Children’s Hospital, Kuopio, Finland
** Vilnius University Children’s Hospital, Vilnius, Lithuania
Paediatric community-acquired pneumonia (PCAP) can be defined clinically as the presence of symptoms and signs of pneumonia in a previously healthy child with acute infection. The final verification of PCAP needs a radiological finding of consolidation of lung parenchyma. In primary care, the diagnosis of PCAP can be done, and the treatment at home started, on the basis of clinical symptoms and signs alone. Viruses are the causative agents of PCAP in 15–35%, and viruses and bacteria together (mixed infection) in 5–35%. Pneumococcal penicillin – resistance is 32% and pneumococcal macrolide – resistance 30–33% worldwide. A history of difficulty in breathing may be more helpful for the diagnostics of PCAC than clinical signs. The main aetiologic classification of PCAP – viral, pneumococcal, or mycoplasmal / chlamydial – is not possible by radiological findings alone. The treatment of PCAP is empiric. Amoxicillin is the first-line antibiotic for the out-patient treatment of PCAC in preschool children group and macrolides – in school children group. Amoxicillin is first-line treat-met in school children group, if S.pneumoniae is probable (fever > 38.5 oC, CRP > 60 mg/L, alveolar infiltrate). Local antibiotic sensitivity patterns should be taken into account.