Community-acquired pneumonia is the presence of signs and symptoms of lower respiratory tract infection acquired outside of the hospital.
The most common bacterial cause of childhood pneumonia is Streptococcus pneumoniae. It usually causes about 1/3 of radiographically-confirmed pneumonia in children <2 years of age.
Viruses commonly affect children <1 year of age than those aged >2 years, respiratory syncytial viruses (RSV) being the most frequently detected virus.
Mixed infection may occur in 8-40% of community-acquired pneumonia cases.
  1. Asghar R, Banajeh S, Egas J, et al. Chloramphenicol versus ampicillin plus gentamicin for community-acquired very severe pneumonia among children 2-59 months in low resource settings: multicentre randomised controlled trial (SPEAR study). Jan 08, 2008. Br Med J. 2008 Jan;336(7635):80-84. doi: 10.1136/bmj.39421.435949.BE. PMID: 18182412
  2. British Thoracic Society Standards of Care Committee. BTS Guidelines for the management of community acquired pneumonia in childhood. Thorax. 2002 May;57(Suppl Suppl 1):i1-i24. PMID: 11994552
  3. Bradley JS, Byington CL, Shah SS, et al. The management of community-acquired pneumonia in infants and children older than 3 months of age: clinical practice guideline by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. Aug 31, 2011. Clin Infect Dis. 2011 Oct;53(7):e25-e76. doi: 10.1093/cid/cir531. Accessed 06 Sep 2011. PMID: 21880587
  4. Harris M, Clark J, Coote N, et al, on behalf of the British Thoracic Society Standards of Care Committee. British Thoracic Society guidelines for the management of community acquired pneumonia in children: update 2011. Thorax. 2011 Oct;66(2):ii1-ii23. doi: 10.1136/thoraxjnl-2011-200598. Accessed 06 Sep 2011. PMID: 21903691
  5. Hazir T, Fox LM, Nisar YB, et al. Ambulatory short-course high-dose oral amoxicillin for treatment of severe pneumonia in children: a randomised equivalency trial. Lancet. 2008 Jan;371(9606):49-56. doi: 10.1016/S0140-6736(08)60071-9. PMID: 18177775
  6. Lakhanpaul M, Atkinson M, Stephenson T. Community acquired pneumonia in children: a clinical update. Arch Dis Child Educ Pract Ed. 2004;89:ep29-ep34. doi: 10.1136/adc.2004.056192.
  7. Kabra SK, Lodha R, Pandey RM. Antibiotics for community acquired pneumonia in children. Cochrane Database Syst Rev. 2006 Jul(3). doi: 10.1002/14651858.CD004874.pub2. PMID: 16856067
  8. Lee PI, Chin CH, Chen PY, et al. Guidelines for the management of community-acquired pneumonia in children. Acta Paediatr Taiwan. 2007;48(4):167-180. PMID: 18265536
  9. Ostapchuk M, Roberts DM, Haddy R. Community-acquired pneumonia in infants and children. Am Fam Physician. 2004 Sep;70(5):899-908. PMID: 15368729
  10. Shah S, Sharieff GQ. Pediatric respiratory infections. Emerg Med Clin North Am. 2007 Nov;25(4):961-979. doi: 10.1016/j.emc.2007.07.006. PMID: 17950132
  11. Russell G. Community acquired pneumonia. Arch Dis Child. 2001 Dec;85(6):445-446. PMID: 11719321
  12. World Health Organization. Guidelines for the management of common illnesses with limited resources. Pocket book of hospital care for children. Geneva, Switzerland: World Health Organization; 2005.
  13. Sandora TJ, Sectish TC. Community acquired pneumonia. In: Kliegman RM, Stanton BF, St Geme JW III, et al, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, PA: Saunders, Elsevier; 2011.
  14. MedWorm
  15. MedWorm
  16. Guideline Development Group. Clinical practice guideline in the evaluation and management of pediatric community acquired pneumonia. Philippine Pediatric Society website. 2004.
  17. Community Acquired Pneumonia Guideline Team, Cincinnati Children’s Hospital Medical Center. Evidence-based guideline for medical management of community acquired pneumonia in children 60 days to 17 years of age. Guideline 14. Cincinnati Children’s Hospital Medical Center. 2005.
  18. The United Nations Children's Funds (UNICEF). Pneumonia: the forgotten killer of children, UNICEF, World Health Organization. Sep 2006.
  19. Alberta Medical Association. The diagnosis and management of community acquired pneumonia: pediatric. 2006.
  20. Academy of Medicine of Malaysia. Clinical practice guidelines on pneumonia and respiratory tract infections in children. Oct 2001. Accessed 14 Sep 2004.
  21. World Health Organization. Revised WHO classification and treatment of childhood pneumonia at health facilities: evidence summaries. World Health Organization website. 2014. Accessed 07 Aug 2015.
  22. Williams DJ, Edwards KM, Self WH, et al. Antibiotic choice for children hospitalized with pneumonia and adherence to national guidelines. Pediatrics. 2015 Jul;136(1):44-52. doi: 10.1542/peds.2014-3047. Accessed 07 Aug 2015. PMID: 26101356
  23. Robinson CL; Advisory Committee on Immunization Practices (ACIP), ACIP Child/Adolescent Immunization Work Group. Advisory Committee on Immunization Practices Recommended Immunization Schedules for Persons Aged 0 Through 18 Years - United States, 2016. MMWR Morb Mortal Wkly Rep. 2016 Feb;65(4):86-87. doi: 10.15585/mmwr.mm6504a4. Accessed 20 May 2016. PMID: 26845283
  24. Barson WJ. Community-acquired pneumonia in children: outpatient treatment. UpToDate. Apr 2017.
  25. Barson WJ. Pneumonia in children: inpatient treatment. UpToDate. Apr 2017.
  26. Centers for Disease Control and Prevention. Recommended immunization schedule for children and adolescents aged 18 years or younger, United States, 2018. 2018.
  27. Haq IJ, Battersby AC, Eastham K, et al. Community acquired pneumonia in children. BMJ. 2017 Mar 2;356:j686. doi: 10.1136/bmj.j686. Accessed 19 Jul 2018. PMID: 28255071
  28. Centers for Disease Control and Prevention (CDC). Recommended child and adolescent immunization schedule for ages 18 years or younger, United States, 2019. CDC. Jan 2019. Accessed 29 May 2019.
  29. Tuomanen EI. Pneumococcal vaccination in children. UptoDate. Apr 2019.
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS JPOG - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
5 days ago
The use of capsule endoscopy (CE) appears to be effective in the diagnosis of iron deficiency anaemia (IDA), yielding a 33.9-percent yield in this study, with 65.8 percent of patients undergoing further workup and 12.7 percent requiring therapeutic intervention.
Tristan Manalac, 4 days ago
Minimally invasive pancreatectomy (MIP) offers a feasible alternative to open pancreatectomy (OP) for the treatment of pancreatic neuroendocrine neoplasms (PNEN), according to a recent Singapore study has found.
Dr. Wong Soon Tee, Yesterday
Acne is a common skin problem seen in primary care. Dr Wong Soon Tee of Assurance Skin Clinic at Mt Elizabeth Novena Hospital, Singapore shares his insights with Pearl Toh on how to manage acne in the primary care setting.
2 days ago
The perception that proton pump inhibitors (PPIs) cause multiple serious adverse effects (AEs) is supported by many internists, who then recommend treatment cessation even in patients at high risk for upper gastrointestinal bleeding (UGIB), reveals a study.