Pediatric infectious diseases have been a common topic for the PedEMMorsels and rightfully so as kids love to collect numerous viral and bacterial infections (ex, Measles, Flu, Mumps, Omphalitis). With that being said, pneumonia is often the topic of conversation in the Peds ED and, thus, deserves special attention. We have discussed pneumonia several times previously (ex, Pneumonia Detective, Round Pneumonia, Penicillin for Pneumonia, and CAP), but recently our friends at the Section on Emergency Medicine at the AAP published a easy to follow guide to Community Acquired Pneumonia (displayed below). Let is take another moment to ensure we are up to date with current recommendations for Pediatric Pneumonia.
Pediatric Pneumonia: Basics
- We see a lot of it – accounts for >500,000 ED visits annually!
- Accounts for ~7% of pediatric admissions.
- Streptococcus pneumoniae is the most common bacterial cause of community acquired pneumonia in kids.
- Narrow spectrum beta-lactam antibiotics are still very effective against S. pneumoniae.
- A significant amount of patients (even after published recommendations) continue to receive unnecessary broad spectrum antibiotics as initial therapy! [Ross, 2014]
Pediatric Pneumonia: Management AlgorithmAAP Pediatric Pneumonia Algorithm 2017
Moral of the Morsel
- Penicillin works well! Most children, even ones who require hospitalization, will benefit from a narrow spectrum penicillin.
- Look for an effusion! The presence of an effusion makes it a more complicated pneumonia and warrants more careful consideration.
- No blood required! The mild and most of the moderate pneumonias will not benefit from extensive blood testing.