Evaluation of Empirical Antibiotic Treatment of Community-Acquired Pneumonia in Children

As the etiology of community-acquired pneumonia is generally unknown at the beginning of treatment, the initial antimicrobial ther­apy is empirical. The aim of this retrospective study was to assess the efficacy of the select­ed empirical treatment, and determine the num­ber of patients in whom the causative agent was identified. We reviewed medical records of children admit­ted to the Department of Infectious Diseases, University Medical Centre Ljubljana, for treatment of community-acquired pneumonia between January 1st 1992 and December 31st 1993. The treatment was considered successful when the elevated body temperature had returned to nor­mal within 48–72 hours of onset. On the 134 patients included in the study, 63 were treated with penicillin G (a 90% success rate) or V (a 92.6% success rate), 19 with cefuroxime (a 84.2% success rate), and 22 with macrolides (a 90.9% success rate). The remain­ing 30 patients were treated with other antibiotics. The pathogen were isolated from blood cul­tures in 8.1% of patients (n = 4/49), while in two out of ten patients the causative agent was iden­tified by serologic tests. In view of the high suc­cess rate of empirical treatment, we recom­mend the use of the proposed therapeutic scheme. Since the available techniques for establishing the etiology of community-acquired pneumonia are time-consuming and only rarely successful, the initial treatment of community- acquired pneumonia in children remains empir­ical.