Community-Acquired Pneumonia in Children.

IF 4.2 Q3 Pharmacology, Toxicology and Pharmaceutics Recent patents on inflammation & allergy drug discovery Pub Date : 2018-01-01 DOI:10.2174/1872213X12666180621163821
Alexander K C Leung, Alex H C Wong, Kam L Hon
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引用次数: 22

Abstract

Background: Community-acquired pneumonia is an important cause of morbidity in developed countries and an important cause of morbidity and mortality in developing countries. Prompt diagnosis and appropriate treatment are very important.

Objective: To provide an update on the evaluation, diagnosis, and treatment of community-acquired pneumonia in children.

Methods: A PubMed search was completed in Clinical Queries using the key term "communityacquired pneumonia". The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews. Patents were searched using the key term "community-acquired pneumonia" from www.google.com/patents, http://espacenet.com, and www. freepatentsonline.com.

Results: Generally, viruses, notably respiratory syncytial virus, are the most common cause of community- acquired pneumonia in children younger than 5 years. Streptococcus pneumoniae is the most common bacterial cause across all age groups. Other important bacterial causes in children younger than 5 years include Haemophilus influenzae, Streptococcus pyogenes, Staphylococcus aureus, and Moraxella catarrhalis. In children 5 years or older, in addition to S. pneumoniae, other important bacterial causes include Mycoplasma pneumoniae and Chlamydophila pneumonia. In the majority of cases, bacterial and viral pneumonia cannot be reliably distinguished from each other on clinical grounds. In practice, most children with pneumonia are treated empirically with antibiotics; the choice of which depends on the patient's age and most likely pathogen. Recent patents related to the management of community-acquired pneumonia are discussed.

Conclusion: In previously healthy children under the age of 5 years, high dose amoxicillin is the treatment of choice. For those with type 1 hypersensitivity to penicillin, clindamycin, azithromycin, clarithromycin, and levofloxacin are reasonable alternatives. For children with a non-type 1 hypersensitivity to penicillin, cephalosporins such as cefixime, cefprozil, cefdinir, cefpodoxime, and cefuroxime should be considered. In previously healthy children over the age of 5 years, macrolides such as azithromycin and clarithromycin are the drugs of choice.

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儿童社区获得性肺炎。
背景:社区获得性肺炎是发达国家发病的重要原因,也是发展中国家发病和死亡的重要原因。及时诊断和适当治疗非常重要。目的:提供儿童社区获得性肺炎的评估、诊断和治疗的最新进展。方法:在临床查询中使用关键词“社区获得性肺炎”完成PubMed检索。检索策略包括荟萃分析、随机对照试验、临床试验、观察性研究和综述。使用关键词“社区获得性肺炎”从www.google.com/patents, http://espacenet.com和www上搜索专利。结果:一般来说,病毒,特别是呼吸道合胞病毒,是5岁以下儿童社区获得性肺炎的最常见原因。肺炎链球菌是所有年龄组中最常见的细菌病因。5岁以下儿童的其他重要细菌病因包括流感嗜血杆菌、化脓性链球菌、金黄色葡萄球菌和卡他莫拉菌。在5岁或以上的儿童中,除了肺炎链球菌外,其他重要的细菌病因包括肺炎支原体和嗜衣原体肺炎。在大多数情况下,细菌性和病毒性肺炎不能根据临床理由可靠地相互区分。在实践中,大多数肺炎儿童都是经验性地使用抗生素治疗;选择哪种取决于病人的年龄和最可能的病原体。讨论了最近与社区获得性肺炎管理相关的专利。结论:在既往健康的5岁以下儿童中,大剂量阿莫西林是首选的治疗方法。对于1型青霉素过敏患者,克林霉素、阿奇霉素、克拉霉素和左氧氟沙星是合理的选择。对于对青霉素非1型过敏的儿童,应考虑使用头孢克肟、头孢丙嗪、头孢地尼、头孢多肟和头孢呋辛等头孢菌素。在以前健康的5岁以上儿童中,阿奇霉素和克拉霉素等大环内酯类药物是首选药物。
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期刊介绍: Recent Patents on Inflammation & Allergy Drug Discovery publishes review articles by experts on recent patents in the field of inflammation and allergy drug discovery e.g. on novel bioactive compounds, analogs and targets. A selection of important and recent patents in the field is also included in the journal. The journal is essential reading for all researchers involved in inflammation and allergy drug design and discovery.
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Meet Our Editorial Board Member Diagnosis of Allergic Reactions to Drugs Non-steroidal Anti-inflammatory Drugs Other Antimicrobial Drugs Biologics: Monoclonal Antibodies for Non-cancer Therapy, Cytokines, Fusion Proteins, Enzymes, and Hormones
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