Pharmacotherapy of childhood pneumonia.
BACKGROUND
Community-acquired pneumonia (CAP) is a leading cause of morbidity and mortality among children under 5 years. Although viral infections have been frequently recognized, death has been attributable to bacterial infections (especially due to Streptococcus pneumoniae).


METHODS
In the past twenty years, childhood mortality due to CAP has been declining because of accessible health care and prompt antibiotic use. The basic options of antibiotics to treat children with CAP are presented.


RESULTS
In daily practice, antibiotic prescription to treat childhood CAP is based on age and severity assessment. For those children aged less than 2 months, hospitalization and parenteral administration of ampicillin plus aminoglycoside or ampicillin plus third-generation cephalosporin is mandatory. For those patients aged 2 months and older with non-severe or severe CAP, the first option is amoxicillin or aqueous penicillin G, respectively; for very severe presentation, oxacillin and third-generation cephalosporin are recommended. If atypical bacteria infection is suspected, macrolide must be given in any age or severity group.


CONCLUSIONS
Few antibiotics are included in the guidelines to treat childhood CAP. The choice of which antibiotic should be given is based on clinical evaluation.
Nascimento-Carvalho
Cristiana M
CM
Federal University of Bahia, School of Medicine, Department of Pediatrics, Rua Prof. Aristides Novis, 105/1201B, Salvador, CEP 40210-630, Brazil. nascimentocarvalho@hotmail.com
D000658:Amoxicillin / Q000009:adverse effects / Q000627:therapeutic use; D000667:Ampicillin / Q000009:adverse effects / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000401:mortality; D004359:Drug Therapy, Combination / Q000379:methods; D064420:Drug-Related Side Effects and Adverse Reactions; D006801:Humans; D010100:Oxygen / Q000378:metabolism; D011014:Pneumonia / Q000188:drug therapy*; D012720:Severity of Illness Index; D013296:Streptococcus pneumoniae / Q000187:drug effects*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000667:Ampicillin; D000658:Amoxicillin; D010100:Oxygen