Vol.66 No.3 May 2018
Treatment of community-acquired pneumonia in children based on the 2017 Guidelines for the Management of Respiratory Infectious Diseases in Children in Japan
Department of Pediatrics, Asahikawa Kosei Hospital, 1-24 Asahikawa, Hokkaido, Japan
Abstract
The pathogenic microorganisms that cause community-acquired pneumonia in children vary depending on the area, timing, and method of data collection. However, at least one third of these microorganisms are considered to be viruses. Therefore, the necessity of antimicrobial drug administration should be determined based on patient symptoms and laboratory test results. The pathogenic microorganisms that should be treated with antibacterial drugs mainly include Streptococcus pneumoniae and Haemophilus influenzae in the case of infants and Mycoplasma pneumoniae in the case of 5- or 6-year-old children. Recently, these pathogenic bacteria have often included resistant strains; therefore, antibacterial drugs must be chosen carefully. Community-acquired pneumonia in children is discussed in the "Guidelines for the Management of Respiratory Infectious Diseases in Children," jointly published by the Japanese Society for Pediatric Infectious Diseases and the Japanese Society of Pediatric Pulmonology. In the newest guidelines published in 2017, amoxicillin is recommended as the first-line treatment when the specific pathogenic microorganisms are not known, but bacterial pneumonia is suspected. However, because H. influenzae is often detected, which shows low sensitivity to amoxicillin, oral cephems (such as cefditoren-pivoxil) are recommended as the second-line treatment. When atypical pneumonia is suspected, macrolides are recommended as the first-line treatment. However, when macrolide-resistant M. pneumoniae is suspected, tosufloxacin (and minocycline if the patient is ≥8 years old) can be chosen. Ampicillin is recommended as a first-line treatment for hospitalized patients.
Key word
community-acquired pneumonia, antibiotic therapy, child
Received
December 18, 2017
Accepted
January 11, 2018
Jpn. J. Chemother. 66 (3): 366-372, 2018
