Comparison between diagnosis and treatment of community-acquired pneumonia in children in various medical centres across Europe with the United States, United Kingdom and the World Health Organization guidelines

Abstract

BackgroundThe aim of this study was to review the current status and usage of guidelines in the diagnosis and treatment of community-acquired pneumonia (CAP) in European countries and to compare to established guidelines in the United States (US), United Kingdom (UK), and the World Health Organization (WHO).MethodsA questionnaire was developed and distributed by the Community-Acquired Pneumonia Paediatric Research Initiative (CAP-PRI) working group and distributed to medical centres across Europe.ResultsOut of 19 European centres, 6 (31.6 %) used WHO guidelines (3 in combination with other guidelines), 5 (26.3 %) used national guidelines, and 5 (26.3 %) used local guidelines. Chest radiograph and complete blood count were the most common diagnostic examinations, while evaluation of clinical symptoms and laboratory tests varied significantly. Tachypnoea and chest recession were considered criteria for diagnosis in all three guidelines. In US and UK guidelines blood cultures, atypical bacterial and viral detection tests were recommended. In European centres in outpatient settings, amoxicillin was used in 16 (84 %) centers, clarithromycin in 9 (37 %) centers and azithromycin in 7 (47 %) centers, whereas in hospital settings antibiotic treatment varied widely. Amoxicillin is recommended as the first drug of choice for outpatient treatment in all guidelines.ConclusionsAlthough local variations in clinical criteria, laboratory tests, and antibiotic resistance rates may necessitate some differences in standard empirical antibiotic regimens, there is considerable scope for standardisation across European centres for the diagnosis and treatment of CAP.Electronic supplementary materialThe online version of this article (doi:10.1186/s41479-016-0005-y) contains supplementary material, which is available to authorized users.

Treatment of Community-Acquired Pneumonia: Are All Countries Treating Children in the Same Way? A Literature Review

“…These analyses highlighted how, even now, adherence to guidelines is still low. On the other hand, Usonis and colleagues through a questionnaire developed and distributed by the CAP Pediatric Research Initiative (CAP-PRI) working group and distributed across Europe showed high adherence to CAP guidelines, with a high prescription rate of narrow-spectrum penicillin for inpatients (amoxicillin (32%) and ampicillin (37%)) and outpatients (amoxicillin (84%)) [ 81 ].…”

Impact of clinical decision support on empirical antibiotic prescribing for children with community‐acquired pneumonia

“…There are no validated CAP severity scores for children, and prognostic indicators are limited . Therefore, we anticipated high rates of inappropriate prescribing and estimated that approximately 50% of uncomplicated CAP would be treated with third‐generation cephalosporins.…”

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