title: An update on antimicrobial options for childhood community-acquired pneumonia: a critical appraisal of available evidence.
abstract: BACKGROUND
  Community-acquired pneumonia (CAP) is a leading cause of death and a major cause of morbidity in children under the age of 5. Appropriate antimicrobial use is one crucial tool in controlling childhood CAP mortality and suffering.
  
  
  METHODS
  Structured search of current literature. PubMed was consulted for published trials conducted in children with CAP. We aimed to provide a comprehensive evaluation of antimicrobials used to treat childhood CAP, including a critical appraisal of the methodological aspects of these clinical trials.
  
  
  CONCLUSIONS
  Amoxicillin is the preferred option to treat non-severe non-complicated CAP among children aged ≥2 months. Amoxicillin may be used to treat children in this age group with severe CAP if they do not require hospital assistance. If the patient warrants hospitalization, intravenous penicillin is the chosen option. Heterogeneity was high in the included trials, in regard to clinical inclusion criteria, use of radiological inclusion criteria, placebo use and masking. Higher quality evidence was found in the studies which included amoxicillin. There is a clear dearth of randomized, placebo-controlled, well-performed clinical trials evaluating children with CAP aged under 2 months, or aged 2 months and above with very severe or complicated CAP, or in specific age groups like teenagers.
authors.affiliation: a Department of Paediatrics , Federal University of Bahia School of Medicine , Salvador CEP 40210-630 , Brazil.
authors.forename: Cristiana M
authors.initials: CM
authors.lastname: Nascimento-Carvalho
authors.affiliation: b Postgraduate Program in Health Sciences , Federal University of Bahia School of Medicine , Salvador CEP 40025-010 , Brazil.
authors.forename: Dafne C
authors.initials: DC
authors.lastname: Andrade
authors.affiliation: b Postgraduate Program in Health Sciences , Federal University of Bahia School of Medicine , Salvador CEP 40025-010 , Brazil.
authors.forename: Ana-Luisa
authors.initials: AL
authors.lastname: Vilas-Boas
mesh_terms: D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000188:drug therapy; D006801:Humans; D007223:Infant; D010406:Penicillins / Q000627:therapeutic use*; D011014:Pneumonia / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic
chemical_list: D000900:Anti-Bacterial Agents; D010406:Penicillins; D000658:Amoxicillin
keywords: acute respiratory infection; antibacterials; lower respiratory tract infection; lung disease