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Pneumonia in children: Inpatient treatment

Author
William J Barson, MD
Section Editors
Morven S Edwards, MD
George B Mallory, MD
Deputy Editor
Mary M Torchia, MD

INTRODUCTION

Community-acquired pneumonia (CAP) is defined as an acute infection of the pulmonary parenchyma in a patient who has acquired the infection in the community, as distinguished from hospital-acquired (nosocomial) pneumonia. CAP is a common and potentially serious illness with considerable morbidity.

The inpatient treatment of CAP and hospital-acquired pneumonia in children will be reviewed here. The outpatient treatment of CAP is discussed separately, as are the epidemiology, etiology, clinical features, and diagnosis. (See "Community-acquired pneumonia in children: Outpatient treatment" and "Pneumonia in children: Epidemiology, pathogenesis, and etiology" and "Community-acquired pneumonia in children: Clinical features and diagnosis".)

The recommendations provided below are largely consistent with practice guidelines provided by The Pediatric Infectious Diseases Society/Infectious Diseases Society of America and the British Thoracic Society [1,2].

HOSPITALIZATION

Indications — The decision to hospitalize a child with community-acquired pneumonia (CAP) is individualized based upon age, underlying medical problems, and clinical factors including severity of illness (table 1) [1-3]. Hospitalization generally is warranted for infants younger than three to six months of age, unless a viral etiology or Chlamydia trachomatis is suspected and they are not hypoxemic and relatively asymptomatic. Hospitalization is also warranted for a child of any age whose family cannot provide appropriate care and assure compliance with the management plan. Additional indications for hospitalization include [1,2]:

Hypoxemia (oxygen saturation [SpO2] <90 percent in room air at sea level)

                                        

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Literature review current through: Nov 2016. | This topic last updated: Fri Dec 02 00:00:00 GMT+00:00 2016.
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