The dilemma of improving rational antibiotic use in pediatric community-acquired pneumonia
Pneumonia is the number one cause of disease and deaths in children under five years old, outside the neonatal period, with the greatest number of cases reported from resource-limited settings. The etiology is variable, with not much information on the local etiology drug resistance profile in many...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-02-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2023.1095166/full |
| _version_ | 1811169339119763456 |
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| author | Phuong T. K. Nguyen Paul D. Robinson Dominic A. Fitzgerald Dominic A. Fitzgerald Ben J. Marais Ben J. Marais |
| author_facet | Phuong T. K. Nguyen Paul D. Robinson Dominic A. Fitzgerald Dominic A. Fitzgerald Ben J. Marais Ben J. Marais |
| author_sort | Phuong T. K. Nguyen |
| collection | DOAJ |
| description | Pneumonia is the number one cause of disease and deaths in children under five years old, outside the neonatal period, with the greatest number of cases reported from resource-limited settings. The etiology is variable, with not much information on the local etiology drug resistance profile in many countries. Recent studies suggest an increasing contribution from respiratory viruses, also in children with severe pneumonia, with an increased relative contribution in settings that have good vaccine coverage against common bacterial pathogens. Respiratory virus circulation was greatly reduced during highly restrictive measures to contain the spread of COVID-19 but rebounded once COVID-19 restrictions were relaxed. We conducted a comprehensive literature review of the disease burden, pathogens, case management and current available prevention of community acquired childhood pneumonia, with a focus on rational antibiotic use, since the treatment of respiratory infections is the leading cause of antibiotic use in children. Consistent application of revised World Health Organisation (WHO) guidance that children presenting with coryzal symptoms or wheeze can be managed without antibiotics in the absence of fever, will help to reduce unnecessary antibiotic use, as will increased availability and use of bedside inflammatory marker tests, such as C–reactive protein (CRP) in children with respiratory symptoms and fever. |
| first_indexed | 2024-04-10T16:40:49Z |
| format | Article |
| id | doaj.art-24bd7668e42242ad82f3743025fcc9e2 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-04-10T16:40:49Z |
| publishDate | 2023-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-24bd7668e42242ad82f3743025fcc9e22023-02-08T07:00:50ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602023-02-011110.3389/fped.2023.10951661095166The dilemma of improving rational antibiotic use in pediatric community-acquired pneumoniaPhuong T. K. Nguyen0Paul D. Robinson1Dominic A. Fitzgerald2Dominic A. Fitzgerald3Ben J. Marais4Ben J. Marais5Department of General Medicine, The Children’s Hospital Westmead, Westmead, NSW, AustraliaDepartment of Respiratory Medicine, The Children’s Hospital Westmead, NSW, AustraliaDepartment of Respiratory Medicine, The Children’s Hospital Westmead, NSW, AustraliaThe University of Sydney, Discipline of Child and Adolescent Health, Faculty of Medicine and Health, Sydney, NSW, AustraliaThe University of Sydney, Discipline of Child and Adolescent Health, Faculty of Medicine and Health, Sydney, NSW, AustraliaDepartment of Infectious Diseases, The Children’s Hospital Westmead, Westmead, NSW, AustraliaPneumonia is the number one cause of disease and deaths in children under five years old, outside the neonatal period, with the greatest number of cases reported from resource-limited settings. The etiology is variable, with not much information on the local etiology drug resistance profile in many countries. Recent studies suggest an increasing contribution from respiratory viruses, also in children with severe pneumonia, with an increased relative contribution in settings that have good vaccine coverage against common bacterial pathogens. Respiratory virus circulation was greatly reduced during highly restrictive measures to contain the spread of COVID-19 but rebounded once COVID-19 restrictions were relaxed. We conducted a comprehensive literature review of the disease burden, pathogens, case management and current available prevention of community acquired childhood pneumonia, with a focus on rational antibiotic use, since the treatment of respiratory infections is the leading cause of antibiotic use in children. Consistent application of revised World Health Organisation (WHO) guidance that children presenting with coryzal symptoms or wheeze can be managed without antibiotics in the absence of fever, will help to reduce unnecessary antibiotic use, as will increased availability and use of bedside inflammatory marker tests, such as C–reactive protein (CRP) in children with respiratory symptoms and fever.https://www.frontiersin.org/articles/10.3389/fped.2023.1095166/fullacute respiratory infectionslower respiratory tract infectionspneumoniaantibioticantimicrobial resistance |
| spellingShingle | Phuong T. K. Nguyen Paul D. Robinson Dominic A. Fitzgerald Dominic A. Fitzgerald Ben J. Marais Ben J. Marais The dilemma of improving rational antibiotic use in pediatric community-acquired pneumonia Frontiers in Pediatrics acute respiratory infections lower respiratory tract infections pneumonia antibiotic antimicrobial resistance |
| title | The dilemma of improving rational antibiotic use in pediatric community-acquired pneumonia |
| title_full | The dilemma of improving rational antibiotic use in pediatric community-acquired pneumonia |
| title_fullStr | The dilemma of improving rational antibiotic use in pediatric community-acquired pneumonia |
| title_full_unstemmed | The dilemma of improving rational antibiotic use in pediatric community-acquired pneumonia |
| title_short | The dilemma of improving rational antibiotic use in pediatric community-acquired pneumonia |
| title_sort | dilemma of improving rational antibiotic use in pediatric community acquired pneumonia |
| topic | acute respiratory infections lower respiratory tract infections pneumonia antibiotic antimicrobial resistance |
| url | https://www.frontiersin.org/articles/10.3389/fped.2023.1095166/full |
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