The Pediatric Infectious Diseases Society (PIDS) and the Infectious Diseases Society of America (IDSA) have issued the first ever guidelines for diagnosing and treating community acquired pediatric pneumonia. The guidelines were compiled by a 13-member panel consisting of representatives from community pediatrics, public health, and the pediatric specialties of critical care, emergency medicine, hospital medicine, infectious diseases, pulmonology, and surgery, and led by John S. Bradley, MD, from the Department of Pediatrics, University of California San Diego School of Medicine and Rady Children's Hospital of San Diego, California. They will be published in the October 1 issue of journal “Clinical Infectious Diseases”. The guidelines consist of 92 recommendations designed to provide assistance in the diagnosis and management of community acquired pneumonia (CAP) in infants and children and lay stress on the importance of immunizations to protect the children from this potentially life threatening condition.
At present, such guidelines are available for the treatment of CAP in adults but no such guidelines had been formulated for pediatric setting. The newly issued guidelines cover aspects like how to diagnose CAP, when to hospitalize a child suffering from CAP, and the course of treatment to be followed in such cases. According to the recommendations, children suffering from CAP, as defined by factors like respiratory distress and hypoxemia should be hospitalized. This should be done even in absence of positive blood tests. The child should be admitted in an intensive care unit if he requires invasive ventilation or non invasive positive pressure ventilation. Blood culture, for the purpose of diagnosis, should be reserved for those children who show continuous deterioration or fail to respond to antibiotic therapy.
The guidelines strongly advocate for annual immunization of all children, above the age of 6 months, for preventing CAP. Amoxicillin should be the antibiotic of choice for treating CAP. In case the child does not respond to it, methicillin resistant staphylococcus aureus may be suspected as the causative agent and be treated accordingly. According to pediatricians, these guidelines fill an important gap in managing CAP in children as there were considerable variations in the line of treatment from one place to another.
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