Immunizations, including a yearly flu vaccine, are the best way to protect children from life-threatening pneumonia, according to new guidelines from the Pediatric Infectious Diseases Society (PIDS) and the Infectious Diseases Society of America (IDSA)
- Current treatment and diagnosis for community-acquired pneumonia (CAP) varies widely. The first guidelines on the diagnosis and treatment of CAP in infants and children provide the most scientifically valid child-specific recommendations.
- Parents should help protect children from potentially deadly pneumonia by ensuring they are up to date on their vaccinations, including taking children 6 months or older for a yearly flu vaccine. Parents and caregivers of infants younger than six months should get a yearly flu vaccine.
- More than 500 U.S children died from pneumonia and other lower respiratory infections in 2006 and the infection kills millions of children worldwide every year.
- Most pneumonia in preschoolers is caused by a virus, will run its course, and won't benefit from antibiotics
The guidelines, which are the first on diagnosing and treating community-acquired pneumonia (CAP) in infants and children, place preventing bacterial pneumonia as a top priority. Published in the Oct. 1 issue of Clinical Infectious Diseases, the guidelines are available online.
Every year, pneumonia kills more than 2 million children ages 5 years and younger worldwide. In the United States, 525 children 15 years old or younger died from pneumonia and other lower respiratory infections in 2006, according to the Centers for Disease Control and Prevention (CDC). While pneumonia can be caused by different types of bugs, in infants and preschool children it usually is caused by a virus, which doesn't need to be treated with antibiotics. However, antibiotics are needed for bacterial pneumonia, which is the most serious type.
Although there are guidelines for diagnosing and treating pneumonia in adults, the course of bacterial pneumonia tends to be different for children. Because of this, practices vary from hospital to hospital, and doctor to doctor. The guidelines from PIDS and IDSA provide all physicians who care for children with a roadmap to the most scientifically valid diagnosis and treatment recommendations.
"Diagnostic methods and treatments that work well in adults may be too risky and not have the desired result in children," said John S. Bradley, MD, lead author of the CAP guidelines and professor and chief of the division of infectious diseases at the University of California at San Diego Department of Pediatrics. "With these guidelines, we are hopeful that the standard and quality of care children receive for community-acquired pneumonia will be consistent from doctor to doctor - providing much better treatment outcomes."
Because viral infections such as influenza can develop into bacterial pneumonia, it's important that children 6 months and older receive a yearly influenza vaccine, according to the guidelines. It is also important that infants and children are up to date on their other scheduled vaccines, several of which prevent bacterial pneumonia. The successful U.S. vaccination program has significantly reduced bacterial pneumonia, and therefore has prevented deaths from the infection, notes Dr. Bradley.
While the guidelines stress the importance of diagnosing pneumonia appropriately, they also warn that over-treatment is a critical concern. For instance, most pneumonia in preschool-aged children is viral, meaning it will run its course and will not develop into life-threatening bacterial pneumonia. In these cases, there is no need to perform unnecessary medical interventions such as using x-rays (which expose the child to radiation needlessly) or prescribing antibiotics (which kill bacteria, not viruses, and may foster drug-resistant bacteria).
"A child with chest congestion, a cough, runny nose and low-grade fever likely has viral pneumonia, and Mother Nature treats those herself," said Dr. Bradley. "If the child has a fever of 104, is barely able to keep fluids down, just wants to lie in bed and is breathing fast, it may be bacterial pneumonia and require antibiotics and hospitalization."