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.
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.

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

“Diagnostic methods and treatments that work well in adults may be too risky and not have the desired result in children,” said John S.

While the guidelines stress the importance of diagnosing pneumonia appropriately, they also warn that over-treatment is a critical concern

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).

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.

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.

Ref: http://www.eurekalert.org/pub_releases/2011-08/idso-aoo083011.php