Pediatric Pneumonia Guidelines: Inconsistencies between Guidelines, Scientific Evidence and Clinical Practice
In 2011 the Pediatric Infectious Diseases Society and the Infectious Diseases
Society of America (IDSA) and the British Thoracic Society created extensive guidelines
with recommendations for the management of community acquired pneumonia in children.
There are a number of recommendations in these guidelines that seem to conflict with
the evidence presented in the guidelines and elsewhere as well as clinical experience.
The perceived disagreement between guidelines and clinical practice may be ours alone, but here are
our thoughts and observations.
In order to accomplish this discussion, we have provided as succinctly as possible
framed quotes from the guidelines that are well documented with references in the actual papers.
Our response to and discussion of the conclusions made by the writers of the guidelines
follow in subsequent paragraphs. Although, extensive references were not required as we are
making the point that the guideline’s recommendations seem to be odds with their own references,
we hope our discussion will encourage the reader to review the actual guidelines to
confirm for themselves whether or not our criticisms are valid.
A theme that is found in both guidelines is that the vast majority of infections
in preschool children and especially under two years of age are viral infections.
Both guidelines make recommendations that minimize investigations and interventions
when viral infections are the suspected etiology.
For the sake of brevity we will need to summarize the Pediatric Infectious
Diseases Society and the Infectious Diseases Society of America and the British
Thoracic Society statements.
Emerg Med Open J. 2015; 1(4): 105-108. doi: 10.17140/EMOJ-1-116
