Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

IDSA/PIDS announce guidelines for treating pneumonia in children

31.08.2011
Immunization, including flu vaccine, can thwart pneumonia in children, guidelines suggest

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).

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.

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."

The guidelines suggest when doctors can feel comfortable not prescribing a higher level of care and when they need to be cautious, and do so. By design, the guidelines lead off with recommendations regarding hospitalization. "Most of these kids will have their first encounter when they have fever and difficulty breathing and see their primary care physician, or the emergency room doctor," said Dr. Bradley. "The first major decision that needs to be made is, is this child well enough to go home, or does he or she need a higher level of care?"

For instance, the guidelines recommend infants 3 to 6 months old with suspected bacterial pneumonia are likely to benefit from hospitalization, even if the pneumonia isn't confirmed by blood tests. Blood testing in children often isn't accurate, so physicians need to pay close attention to symptoms, and, if unsure, err on the side of treating, said Dr. Bradley.

Following are some other recommendations included in the guidelines:

Because infants 6 months and younger cannot get the flu shot or nasal spray, their parents and caregivers should be sure to get the vaccine.
When antibiotics are necessary, amoxicillin should be first-line therapy for bacterial pneumonia, because it is safe and effective. Many doctors prescribe more powerful antibiotics, which are unnecessary and can kill off good bacteria in the body.

Although pneumonia from methicillin-resistant Staphylococcus aureus (MRSA) is uncommon, it can cause severe illness, so physicians need to consider it if a child doesn't improve after first-line antibiotic therapy.

For each of the 92 specific recommendations, the guidelines denote the strength of the recommendation as well as the quality of evidence for each. The guidelines note the lack of solid evidence in some areas – often due to the ethical challenges of studying children – and call for research in specific areas.

"We're hopeful that in following these guidelines, physicians and hospitals will collect data and the results can be compared," said Dr. Bradley. "We envision this as the first of many revisions of guidelines to come."

The 13-member guidelines panel was comprised of experts from around the country, including lung, emergency department, hospital medicine and critical care specialists, office-based pediatricians, pediatric surgeons and CDC epidemiologists. They reviewed hundreds of scientific studies, papers and presentations in preparation for writing the guidelines. In addition to Dr. Bradley, the panel included: Carrie L. Byington, Samir S. Shah, Brian Alverson, Edward R. Carter, Christopher Harrison, Sheldon L. Kaplan, Sharon E. Mace, George H. McCracken, Jr., Matthew R. Moore, Shawn D. St. Peter, Jana A. Stockwell and Jack T. Swanson.

IDSA has published more than 50 treatment guidelines on various conditions and infections, ranging from HIV/AIDS to Clostridium difficile. As with other IDSA guidelines, the CAP in children guidelines will be available in a format designed for iPhones and other mobile devices, and in a pocket-sized quick-reference edition. These are the first guidelines published by PIDS.

Note: For a copy of The Management of Community-Acquired Pneumonia (CAP) in Infants and Children Older than 3 months of Age: Clinical Practice Guidelines by the Pediatric Infectious Diseases Society (PIDS) and the Infectious Diseases Society of America (IDSA), to be published in the October 1 issue of Clinical Infectious Diseases, please contact Ashley Mattys at (312) 558-1770 or amattys@pcipr.com. The guidelines are embargoed until Aug. 31, 2011 at 12:01 a.m. ET, when they will be posted online.

The Pediatric Infectious Diseases Society (PIDS) is an organization of more than 1,000 specialists in pediatric infectious diseases, covering areas from basic and clinical research to patient care. PIDS' mission is to enhance the health of infants, children and adolescents by promoting excellence in diagnosis, management and prevention of infectious diseases through clinical care, education, research and advocacy. PIDS represents the leading practitioners, policy-makers and researchers who work with children's infectious diseases. For more information, visit www.pids.org.

The Infectious Diseases Society of America (IDSA) is an organization of physicians, scientists, and other health care professionals dedicated to promoting health through excellence in infectious diseases research, education, patient care, prevention, and public health. The Society, which has more than 9,000 members, was founded in 1963 and is based in Arlington, Va. For more information, visit www.idsociety.org.

Ashley Mattys | EurekAlert!
Further information:
http://www.idsociety.org

More articles from Health and Medicine:

nachricht Minimising risks of transplants
22.02.2018 | Friedrich-Alexander-Universität Erlangen-Nürnberg

nachricht FAU researchers demonstrate that an oxygen sensor in the body reduces inflammation
22.02.2018 | Friedrich-Alexander-Universität Erlangen-Nürnberg

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Developing reliable quantum computers

International research team makes important step on the path to solving certification problems

Quantum computers may one day solve algorithmic problems which even the biggest supercomputers today can’t manage. But how do you test a quantum computer to...

Im Focus: In best circles: First integrated circuit from self-assembled polymer

For the first time, a team of researchers at the Max-Planck Institute (MPI) for Polymer Research in Mainz, Germany, has succeeded in making an integrated circuit (IC) from just a monolayer of a semiconducting polymer via a bottom-up, self-assembly approach.

In the self-assembly process, the semiconducting polymer arranges itself into an ordered monolayer in a transistor. The transistors are binary switches used...

Im Focus: Demonstration of a single molecule piezoelectric effect

Breakthrough provides a new concept of the design of molecular motors, sensors and electricity generators at nanoscale

Researchers from the Institute of Organic Chemistry and Biochemistry of the CAS (IOCB Prague), Institute of Physics of the CAS (IP CAS) and Palacký University...

Im Focus: Hybrid optics bring color imaging using ultrathin metalenses into focus

For photographers and scientists, lenses are lifesavers. They reflect and refract light, making possible the imaging systems that drive discovery through the microscope and preserve history through cameras.

But today's glass-based lenses are bulky and resist miniaturization. Next-generation technologies, such as ultrathin cameras or tiny microscopes, require...

Im Focus: Stem cell divisions in the adult brain seen for the first time

Scientists from the University of Zurich have succeeded for the first time in tracking individual stem cells and their neuronal progeny over months within the intact adult brain. This study sheds light on how new neurons are produced throughout life.

The generation of new nerve cells was once thought to taper off at the end of embryonic development. However, recent research has shown that the adult brain...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

2nd International Conference on High Temperature Shape Memory Alloys (HTSMAs)

15.02.2018 | Event News

Aachen DC Grid Summit 2018

13.02.2018 | Event News

How Global Climate Policy Can Learn from the Energy Transition

12.02.2018 | Event News

 
Latest News

Stiffness matters

22.02.2018 | Life Sciences

Magnetic field traces gas and dust swirling around supermassive black hole

22.02.2018 | Physics and Astronomy

First evidence of surprising ocean warming around Galápagos corals

22.02.2018 | Earth Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>