New Recommendations for Pediatric Pneumonia Treatment

Author: John S Bradley, MD
Pediatric Infectious Disease Specialist at
Rady Children’s Hospital and Health Center

Every year, pneumonia kills more than 2 million children ages 5 years and younger worldwide. Yet the only existing national guidelines for the treatment of pneumonia focus on adults, and the recommended diagnostic methods and treatments may be too risky and not have the desired result in children.

After two years of work, my colleagues from various backgrounds and I have completed the first-ever comprehensive national guidelines on diagnosing and treating infants and children affected by this life-threatening disease: “The Management of Community-Acquired Pneumonia in Infants and Children Older Than 3 Months of Age: Clinical Practice Guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America.”

These guidelines contain exhaustive input from many different specialties to provide important new information on pneumonia treatment and prevention for doctors, nurse practitioners and physician’s assistants. For instance, antibiotic-resistant bacteria that used to cause pneumonia are now rare, thanks to immunizations, and for the first time in 40 years, we can prescribe ampicillin (or even penicillin) to effectively treat the disease. For kids who are not as sick and can be treated at home, plain old, safe (and tasty) amoxicillin is again the preferred antibiotic. We’ve also documented that most kids diagnosed with pneumonia actually have viral chest colds – and of course, do NOT need antibiotics for treatment.

Pneumonia guidelines wouldn’t be complete without giving credit to the routine pneumococcal and Haemophilus influenzae type b (Hib) vaccines now provided to all U.S. children for dramatically decreasing contraction of bacterial pneumonia. We need to keep up the good work! Because influenza can make a child more susceptible to bacterial pneumonia, it is essential to immunize kids annually with the flu vaccine. We all can agree that it’s better to prevent disease and suffering than to need to treat it.

There is a summary of the guidelines in the first few pages of the document, which consists of 52 pages of recommendations backed by 340 references. Keep in mind that these are only meant to guide providers, who must use their best judgment in treating each child. We’re hopeful that these guidelines will spur physicians and hospitals to collect data and compare their results, enabling us to revise the guidelines over time.

Dr. John S. Bradley is a pediatric infectious disease specialist at Rady Children’s Hospital and Chief of the Division of Pediatric Diseases at University of California, San Diego School of Medicine, with a great interest in improving care to children through clinical research and the creation of clinical guidelines