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Recommendations for treatment of childhood non-severe pneumonia

Grant, G., Campbell, H., Dowell, S., Graham, S., Klugman, K., Mulholland, E. Kim, Steinhoff, M., Weber, M. and Qazi, S. (2009). Recommendations for treatment of childhood non-severe pneumonia. Lancet Infectious Diseases,9(3):185-196.

Document type: Journal Article

IRMA ID 10666xPUB28
Title Recommendations for treatment of childhood non-severe pneumonia
Author Grant, G.
Campbell, H.
Dowell, S.
Graham, S.
Klugman, K.
Mulholland, E. Kim
Steinhoff, M.
Weber, M.
Qazi, S.
Journal Name Lancet Infectious Diseases
Publication Date 2009
Volume Number 9
Issue Number 3
ISSN 1473-3099   (check CDU catalogue open catalogue search in new window)
Start Page 185
End Page 196
Total Pages 12
Place of Publication UK
Publisher The Lancet Publishing Group
HERDC Category C1 - Journal Article (DEST)
Abstract WHO recommendations for early antimicrobial treatment of childhood pneumonia have been effective in reducing childhood mortality, but the last major revision was over 10 years ago. The emergence of antimicrobial resistance, new pneumonia pathogens, and new drugs have prompted WHO to assemble an international panel to review the literature on childhood pneumonia and to develop evidence-based recommendations for the empirical treatment of non-severe pneumonia among children managed by first-level health providers. Treatment should target the bacterial causes most likely to lead to severe disease, including Streptoccocus pneumoniae and Haemophilus influenzae. The best first-line agent is amoxicillin, given twice daily for 3—5 days, although co-trimoxazole may be an alternative in some settings. Treatment failure should be defined in a child who develops signs warranting immediate referral or who does not have a decrease in respiratory rate after 48—72 h of therapy. If failure occurs, and no indication for immediate referral exists, possible explanations for failure should be systematically determined, including non-adherence to therapy and alternative diagnoses. If failure of the first-line agent remains a possible explanation, suitable second-line agents include high-dose amoxicillin—clavulanic acid with or without an affordable macrolide for children over 3 years of age.
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Created: Tue, 02 Mar 2010, 21:51:15 CST by Sarena Wegener