Complications in community acquired pneumonia: magnitude of problem, risk factors, and management in pediatric age

Esposito, Susanna; Canto, Giulia Dal; Caramia, Maria Rosaria; Fainardi, Valentina; Pisi, Giovanna; Principi, Nicola

doi:10.1080/14787210.2021.1927710

Cited by 6 publications

(5 citation statements)

References 68 publications

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“…The early detection and proper management of dysphagia, including adequate nutritional management and successful swallowing rehabilitation, may help prevent malnutrition and pneumonia in stroke patients ( 8 , 11 ). Early pneumonia prevention is essential to reduce serious respiratory complications, such as respiratory failure, lung abscess, necrosis, sepsis, and death after stroke ( 8 , 28 ).…”

Section: Discussionmentioning

confidence: 99%

The Relationship Between Dysphagia and Pneumonia in Acute Stroke Patients: A Systematic Review and Meta-Analysis

et al. 2022

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BackgroundDysphagia is a common complication after stroke and is associated with the development of pneumonia. This study aimed to summarize the relationship between dysphagia and pneumonia in post-stroke patients.Materials and MethodsArticles published up to November 2021 were searched in the PubMed, Embase, Cochrane library, and Scopus databases. Studies that investigated the development of pneumonia in acute stroke patients with and without dysphagia were included. The methodological quality of individual studies was evaluated using the Risk Of Bias In Non-randomized Studies-of Interventions tool, and publication bias was evaluated using a funnel plot and Egger's test.ResultsOf 5,314 studies, five studies were included in the meta-analysis. The results revealed that the incidence of pneumonia was significantly higher in the dysphagia group than in the non-dysphagia group (OR 9.60; 95% CI 5.75–16.04; p < 0.0001; I2 = 78%). There was no significant difference in the mortality rate between the two groups (OR 5.64; 95% CI 0.83–38.18; p = 0.08; I2 = 99%).ConclusionDysphagia is a significant risk factor for pneumonia after stroke. The early diagnosis and treatment of dysphagia in stroke patients are important to prevent stroke-associated pneumonia.

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Section: Discussionmentioning

confidence: 99%

The Relationship Between Dysphagia and Pneumonia in Acute Stroke Patients: A Systematic Review and Meta-Analysis

et al. 2022

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“…On the contrary, in industrialized countries, some efforts for a more accurate identification of CAP cases and, among these, of those of bacterial origin have been made. Laboratory tests, chest radiograph and respiratory secretion culture were included among the criteria used to diagnose CAP ( Esposito et al, 2022 ). For example, in a study carried out in Israel only cases with radiological evidence of alveolar CAP were enrolled ( Greenberg et al, 2014 ).…”

Section: Community-acquired Pneumonia (Cap)mentioning

confidence: 99%

“…In complicated CAP cases requiring hospitalization it was generally state that duration of antibiotic administration should have been individualized mainly on the basis of patient and disease characteristics. Ten days or even longer period of therapy for very complicated cases were suggested ( Esposito et al, 2022 ). Different results were obtained when children with mild to moderate CAP followed in the outpatient setting were studied.…”

Section: Community-acquired Pneumonia (Cap)mentioning

confidence: 99%

Short-term antibiotic therapy for the most common bacterial respiratory infections in infants and children

et al. 2023

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Overuse and misuse of antibiotics have strongly accelerated the progressive increase in bacterial antimicrobial resistance (AMR). The evidence that antimicrobial selective pressure was greater the longer the antibiotic therapy was continued has led some experts to reconsider duration of antibiotic therapy testing the use of short-term drug administration. If as effective as long-term therapy, short-term therapy could have been an easy measure to limit AMR emergence. In the present narrative review, whether present knowledge on short-term therapy of acute streptococcal pharyngitis (ASF), acute otitis media (AOM) and mild to moderate community-acquired pneumonia (CAP) allows systematic use of short-term therapy in infants and children with these diseases is discussed. Literature analysis showed that reducing the duration of antibiotic therapy for some of the most common pediatric respiratory infections could be a valid measure to contain the antibiotic abuse and the consequent impact on the emergence of AMR. Several data seem to indicate that this type of intervention is possible, as short-term therapy has been found as effective as the traditionally recommended long-term therapy in some cases of ASF, AOM and mild to moderate CAP. However, further studies are needed to better characterize infants and children who can have benefit with short-term antibiotic therapy in common bacterial respiratory infections.

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“…A high index of suspicion is needed to anticipate pulmonary complications, especially if a child becomes unwell or develops a fever 48 h after initiating medication. These complications can include lung abscesses, necrotizing pneumonia, pleural effusion, and/or empyema [3].…”

Section: Introductionmentioning

confidence: 99%

Mean platelet volume and D-dimer as predictors for complicated community-acquired pneumonia in hospitalized children

Elmeazawy,

Toema,

Mobarak

2024

Egypt Pediatric Association Gaz

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Background Community-acquired pneumonia (CAP) is one of the primary causes of child mortality and morbidity. The primary objective of our research was to assess the value of mean platelet volume (MPV) and D-dimer levels in predicting complicated community-acquired pneumonia in hospitalized children. Methods This observational retrospective study gathered medical data from the electronic medical records of children diagnosed with CAP who were admitted to the Pediatric Pulmonology Unit between December 2021 and December 2022. Results This study included 154 pediatric patients. Their age at presentation was 4.15 ± 3.60 years. A comparison of patients with complicated CAP and non-complicated CAP revealed a statistically significant decrease of MPV in the complicated CAP group than in the non-complicated group (p = 0.016). The D-dimer level was significantly higher in the complicated CAP 3.42 ± 3.02 µg/ml compared than in the non-complicated 1.63 ± 2.04 µg/ml, p = 0.002). Low MPV and increased D-dimer were powerful indicators of complicated CAP (OR 0.577, p = 0.021, OR 1.419, p = 0.003). Conclusion The current study highlights that low MPV and high D-dimer levels can be useful predictors of pulmonary complications of CAP in children. However, prospective observational studies are needed to evaluate the changes in these predictors during the disease and assess the time needed for normalization.

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Complications in community acquired pneumonia: magnitude of problem, risk factors, and management in pediatric age

Cited by 6 publications

References 68 publications

The Relationship Between Dysphagia and Pneumonia in Acute Stroke Patients: A Systematic Review and Meta-Analysis

The Relationship Between Dysphagia and Pneumonia in Acute Stroke Patients: A Systematic Review and Meta-Analysis

Short-term antibiotic therapy for the most common bacterial respiratory infections in infants and children

Mean platelet volume and D-dimer as predictors for complicated community-acquired pneumonia in hospitalized children

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