The Management of Community-Acquired Pneumonia in Infants and Children Older Than 3 Months of Age: Clinical Practice Guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America

Abstract Evidenced-based guidelines for management of infants and children with community-acquired pneumonia (CAP) were prepared by an expert panel comprising clinicians and investigators representing community pediatrics, public health, and the pediatric specialties of critical care, emergency medicine, hospital medicine, infectious diseases, pulmonology, and surgery. These guidelines are intended for use by primary care and subspecialty providers responsible for the management of otherwise healthy infants and children with CAP in both outpatient and inpatient settings. Site-of-care management, diagnosis, antimicrobial and adjunctive surgical therapy, and prevention are discussed. Areas that warrant future investigations are also highlighted.

[1]  O. Ruuskanen,et al.  Procalcitonin is useful in identifying bacteraemia among children with pneumonia , 2010, Scandinavian journal of infectious diseases.

[2]  R. Freeman,et al.  Community acquired pneumonia—a prospective UK study , 2000, Archives of disease in childhood.

[3]  C. Muñoz-Almagro,et al.  Identification of pneumococcal serotypes from culture-negative clinical specimens by novel real-time PCR. , 2008, Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases.

[4]  J. Raboud,et al.  Antiviral therapy and outcomes of influenza requiring hospitalization in Ontario, Canada. , 2007, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[5]  Craig S. Wong,et al.  Invasive pneumococcal disease and hemolytic uremic syndrome. , 2002, Pediatrics.

[6]  Kurt Olsen,et al.  Epidemiology and clinical characteristics of community-acquired pneumonia in hospitalized children. , 2004, Pediatrics.

[7]  A. Hoes,et al.  Invasive pneumococcal and meningococcal disease: association with influenza virus and respiratory syncytial virus activity? , 2008, Epidemiology and Infection.

[8]  D. Nadal,et al.  Pulmonary and systemic bacterial co-infections in severe RSV bronchiolitis , 2004, Archives of Disease in Childhood.

[9]  O. Ruuskanen,et al.  Diagnosis of Mycoplasma pneumoniaePneumonia in Children , 1998, Journal of Clinical Microbiology.

[10]  T. Ishida,et al.  A 3-year prospective study of a urinary antigen-detection test for Streptococcus pneumoniae in community-acquired pneumonia: utility and clinical impact on the reported etiology , 2004, Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy.

[11]  C. Byington,et al.  An epidemiological investigation of a sustained high rate of pediatric parapneumonic empyema: risk factors and microbiological associations. , 2002, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[12]  Irene le Roux,et al.  Combined use of pleural adenosine deaminase with lymphocyte/neutrophil ratio. Increased specificity for the diagnosis of tuberculous pleuritis. , 1996, Chest.

[13]  G. Mccracken,et al.  Unique considerations in the evaluation of antibacterials in clinical trials for pediatric community-acquired pneumonia. , 2008, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[14]  S. C. Spalding.  Comparison of Standard Versus Double Dose of Amoxicillin in the Treatment of Non-Severe Pneumonia in Children Aged 2–59 Months: A Multi-Centre, Double Blind, Randomised Controlled Trial in Pakistan , 2007 .

[15]  R. Prescott,et al.  The clinical course and management of thoracic empyema. , 1996, QJM : monthly journal of the Association of Physicians.

[16]  S. Black,et al.  Changing Epidemiology of Outpatient Bacteremia in 3- to 36-Month-Old Children After the Introduction of the Heptavalent-Conjugated Pneumococcal Vaccine , 2006, The Pediatric infectious disease journal.

[17]  Y. Benito,et al.  Streptococcus pneumoniae thoracic empyema in children: rapid diagnosis by using the Binax NOW immunochromatographic membrane test in pleural fluids. , 2006, Pathologie-biologie.

[18]  K. Monroe,et al.  Impact of the rapid diagnosis of influenza on physician decision-making and patient management in the pediatric emergency department: results of a randomized, prospective, controlled trial. , 2003, Pediatrics.

[19]  J. Stockman.  Lack of Predictive Value of Tachypnea in the Diagnosis of Pneumonia in Children , 2012 .

[20]  R. Silbergleit,et al.  Blood cultures for community-acquired pneumonia: are they worthy of two quality measures? A systematic review. , 2009, Journal of hospital medicine.

[21]  C. Muñoz-Almagro,et al.  Pediatric Parapneumonic Empyema, Spain , 2008, Emerging infectious diseases.

[22]  H. Davies,et al.  Reliability of the chest radiograph in the diagnosis of lower respiratory infections in young children. , 1996, The Pediatric infectious disease journal.

[23]  F. Bloomfield,et al.  Inter- and intra-observer variability in the assessment of atelectasis and consolidation in neonatal chest radiographs , 1999, Pediatric Radiology.

[24]  S. Jaffar,et al.  Risk factors for mortality among children hospitalized because of acute respiratory infections in Bangui, Central African Republic , 2000, The Pediatric infectious disease journal.

[25]  S. Dowell,et al.  Evaluation of Binax NOW, an assay for the detection of pneumococcal antigen in urine samples, performed among pediatric patients. , 2001, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[26]  C. Glaser,et al.  Rapid Influenza Antigen Test for Diagnosis of Pandemic (H1N1) 2009 , 2010, Emerging infectious diseases.

[27]  M. Leinonen,et al.  Etiological diagnosis of childhood pneumonia by use of transthoracic needle aspiration and modern microbiological methods. , 2002, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[28]  G. Mccracken,et al.  Parapneumonic effusions and empyema in hospitalized children: a retrospective review of 227 cases. , 1984, Pediatric infectious disease.

[29]  R. Steele,et al.  Formulations of Antibiotics for Children in Primary Care , 2002, Paediatric drugs.

[30]  D. Gendrel.  Antibiotic treatment of mycoplasma pneumoniae infections , 1997, Pediatric pulmonology. Supplement.

[31]  Committee on Infectious Diseases. Policy Statement: Recommendations for Prevention and Control of Influenza in Children, 2012–2013. Pediatrics. 2012;130(4):780–792 , 2013, Pediatrics.

[32]  G. Swingler,et al.  Randomised controlled trial of clinical outcome after chest radiograph in ambulatory acute lower-respiratory infection in children , 1998, The Lancet.

[33]  Jean-Yves Fagon,et al.  Ventilator-associated pneumonia. , 2002, American journal of respiratory and critical care medicine.

[34]  T. Ten Have,et al.  Primary early thoracoscopy and reduction in length of hospital stay and additional procedures among children with complicated pneumonia: results of a multicenter retrospective cohort study. , 2008, Archives of pediatrics & adolescent medicine.

[35]  L. Brammer,et al.  Influenza-Associated Pediatric Mortality in the United States: Increase of Staphylococcus aureus Coinfection , 2008, Pediatrics.

[36]  Wendy J. Pomerantz,et al.  Effect of point-of-care influenza testing on management of febrile children. , 2006, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[37]  Y. Sivan,et al.  The yield of flexible fiberoptic bronchoscopy in pediatric intensive care patients. , 2004, Chest.

[38]  J. Kline,et al.  Intraobserver and interobserver agreement of the interpretation of pediatric chest radiographs , 2010, Emergency Radiology.

[39]  M. Granström,et al.  Etiology of community‐acquired pneumonia in children based on antibody responses to bacterial and viral antigens , 1989, The Pediatric infectious disease journal.

[40]  R. Keren,et al.  Complications of Central Venous Catheters Used for the Treatment of Acute Hematogenous Osteomyelitis , 2006, Pediatrics.

[41]  A. Localio,et al.  Prolonged Intravenous Therapy Versus Early Transition to Oral Antimicrobial Therapy for Acute Osteomyelitis in Children , 2009, Pediatrics.

[42]  S. R. Snodgrass,et al.  Pediatric Patients With Undetectable Anticonvulsant Blood Levels: Comparison With Compliant Patients , 2001, Journal of child neurology.

[43]  J. Bradley,et al.  Invasive bacterial disease in childhood: efficacy of oral antibiotic therapy following short course parenteral therapy in non-central nervous system infections. , 1987, The Pediatric infectious disease journal.

[44]  M. Fine,et al.  Assessing prognosis and selecting an initial site of care for adults with community-acquired pneumonia. , 1998, Infectious disease clinics of North America.

[45]  J. Collie.  Malingering in Accident and Disease , 1913 .

[46]  M. Fine,et al.  Time to clinical stability in patients hospitalized with community-acquired pneumonia: implications for practice guidelines. , 1998, JAMA.

[47]  David N Fisman,et al.  Guideline-concordant therapy and reduced mortality and length of stay in adults with community-acquired pneumonia: playing by the rules. , 2009, Archives of internal medicine.

[48]  D. Prais,et al.  Association of Hypoalbuminemia With the Presence and Size of Pleural Effusion in Children With Pneumonia , 2008, Pediatrics.

[49]  D. Leland,et al.  Performance of Meridian ImmunoCard Mycoplasma test in a multicenter clinical trial , 1996, Journal of clinical microbiology.

[50]  N. Tsarouhas,et al.  Effectiveness of intramuscular penicillin versus oral amoxicillin in the early treatment of outpatient pediatric pneumonia , 1998, Pediatric emergency care.

[51]  L. Hoffman,et al.  Management of children with empyema: Pleural drainage is not always necessary , 2010, Pediatric pulmonology.

[52]  E. Acosta,et al.  Determination of Appropriate Dosing of Influenza Drugs in Pediatric Patients , 2010, Clinical pharmacology and therapeutics.

[53]  S. Remes,et al.  Serum procalcitonin in pneumococcal pneumonia in children. , 2001, The European respiratory journal.

[54]  R. Jackson,et al.  Early Video-assisted Thoracic Surgery in the Management of Empyema , 1999, Pediatrics.

[55]  T. Heikkinen,et al.  Early oseltamivir treatment of influenza in children 1-3 years of age: a randomized controlled trial. , 2010, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[56]  A. Torres,et al.  Treatment failure in community-acquired pneumonia. , 2007, Chest.

[57]  J. Dorca,et al.  Contribution of a urinary antigen assay (Binax NOW) to the early diagnosis of pneumococcal pneumonia. , 2004, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[58]  J. Dorca,et al.  Usefulness of betalactam therapy for community-acquired pneumonia in the era of drug-resistant Streptococcus pneumoniae: a randomized study of amoxicillin-clavulanate and ceftriaxone. , 2001, Microbial drug resistance.

[59]  W. Callaghan,et al.  Pandemic 2009 influenza A(H1N1) virus illness among pregnant women in the United States. , 2010, JAMA.

[60]  H. Schroten,et al.  Frequent Detection of Viral Coinfection in Children Hospitalized With Acute Respiratory Tract Infection Using a Real-Time Polymerase Chain Reaction , 2008, The Pediatric infectious disease journal.

[61]  M. Harper,et al.  Bacteremia-associated pneumococcal pneumonia and the benefit of initial parenteral antimicrobial therapy. , 1999, The Pediatric infectious disease journal.

[62]  S. Stanojevic,et al.  Comparison of urokinase and video-assisted thoracoscopic surgery for treatment of childhood empyema. , 2006, American journal of respiratory and critical care medicine.

[63]  Chin‐Yun Lee,et al.  Guidelines for the management of community-acquired pneumonia in children. , 2007, Acta paediatrica Taiwanica = Taiwan er ke yi xue hui za zhi.

[64]  J. Plouffe,et al.  Importance of atypical pathogens of community-acquired pneumonia. , 2000, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[65]  S. Delport,et al.  Aetiology and outcome of severe community-acquired pneumonia in children admitted to a paediatric intensive care unit. , 2002, South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde.

[66]  M. Fine,et al.  Causes of death for patients with community-acquired pneumonia: results from the Pneumonia Patient Outcomes Research Team cohort study. , 2002, Archives of internal medicine.

[67]  Samir S. Shah,et al.  Risk of bacteremia in young children with pneumonia treated as outpatients. , 2003, Archives of pediatrics & adolescent medicine.

[68]  R. Freeman,et al.  Cavitatory lung disease complicating empyema in children , 2006, Pediatric pulmonology.

[69]  D. Commerce.  Statistical abstract of the United States , 1978 .

[70]  Keiji Fukuda,et al.  Influenza-associated deaths among children in the United States, 2003-2004. , 2005, The New England journal of medicine.

[71]  R. Hopstaken,et al.  Inter-observer variation in the interpretation of chest radiographs for pneumonia in community-acquired lower respiratory tract infections. , 2004, Clinical radiology.

[72]  Mark A. Miller,et al.  Projected cost-effectiveness of pneumococcal conjugate vaccination of healthy infants and young children. , 2000, JAMA.

[73]  C. Byington,et al.  Epidemiology, Complications, and Cost of Hospitalization in Children With Laboratory-Confirmed Influenza Infection , 2006, Pediatrics.

[74]  J. Fulton,et al.  Comparison of laboratory diagnostic procedures for detection of Mycoplasma pneumoniae in community outbreaks. , 2009, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[75]  J. Kobr,et al.  Treatment of encapsulated pleural effusions in children: A prospective trial , 2009, Pediatrics international : official journal of the Japan Pediatric Society.

[76]  R. Walker,et al.  Live attenuated versus inactivated influenza vaccine in infants and young children. , 2007, The New England journal of medicine.

[77]  W. Bonadio.  Bacteremia in febrile children with lobar pneumonia and leukocytosis , 1988, Pediatric emergency care.

[78]  C. Xavier,et al.  [Changes in placental morphology of small for gestational age newborns]. , 2002, Jornal de pediatria.

[79]  A. Ferguson,et al.  Gram-positive toxic shock syndromes. , 2009, The Lancet. Infectious diseases.

[80]  Ronald N. Jones,et al.  Rationale for revised penicillin susceptibility breakpoints versus Streptococcus pneumoniae: coping with antimicrobial susceptibility in an era of resistance. , 2009, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[81]  M. Korppi,et al.  Incidence of community‐acquired pneumonia in children caused by Mycoplasma pneumoniae: Serological results of a prospective, population‐based study in primary health care , 2004, Respirology.

[82]  J. Bartlett,et al.  Community-acquired pneumonia. , 2013, The New England journal of medicine.

[83]  G. Forrest,et al.  Rifampin Combination Therapy for Nonmycobacterial Infections , 2010, Clinical Microbiology Reviews.

[84]  M. Leinonen,et al.  Etiology of childhood pneumonia: serologic results of a prospective, population-based study. , 1998, The Pediatric infectious disease journal.

[85]  M. Fine,et al.  Processes and outcomes of care for patients with community-acquired pneumonia: results from the Pneumonia Patient Outcomes Research Team (PORT) cohort study. , 1999, Archives of internal medicine.

[86]  C. Byington,et al.  Temporal trends of invasive disease due to Streptococcus pneumoniae among children in the intermountain west: emergence of nonvaccine serogroups. , 2005, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[87]  M. Leinonen,et al.  Erythrocyte sedimentation rate, white blood cell count and serum C-reactive protein in assessing etiologic diagnosis of acute lower respiratory infections in children. , 1995, The Pediatric infectious disease journal.

[88]  J. Bushyhead,et al.  The Effect of Chest Radiographs on the Management and Clinical Course of Patients With Acute Cough , 1983, Medical care.

[89]  Ron M. Walls,et al.  Rosen's Emergency Medicine - Concepts and Clinical Practice, 2-Volume Set, 8th Edition , 2003 .

[90]  Heather Duncan,et al.  The Pediatric Early Warning System score: a severity of illness score to predict urgent medical need in hospitalized children. , 2006, Journal of critical care.

[91]  Mogabgab Wj.  Therapeutic effect of erythromycin on Mycoplasma pneumoniae pneumonia. , 1965 .

[92]  J. Bonnet,et al.  Detection of Mycoplasma pneumoniae by using the polymerase chain reaction. , 1989, Journal of clinical microbiology.

[93]  H. Salomón,et al.  Acute lower respiratory infection in Argentinian children: A 40 month clinical and epidemiological study , 1993, Pediatric pulmonology.

[94]  R. Markowitz,et al.  Usefulness of chest radiographs in children with acute lower respiratory tract disease. , 1987, Jornal de Pediatria.

[95]  E. Larson,et al.  A Review of Antimicrobial Control Strategies in Hospitalized and Ambulatory Pediatric Populations , 2007, The Pediatric infectious disease journal.

[96]  O. Ruuskanen,et al.  Etiology of community‐acquired pneumonia in 254 hospitalized children , 2000, The Pediatric infectious disease journal.

[97]  H. Kinney,et al.  Bacterial Pathogens and Death during the 1918 Influenza Pandemic , 2009 .

[98]  D. Bates,et al.  Do emergency department blood cultures change practice in patients with pneumonia? , 2005, Annals of emergency medicine.

[99]  M. Fine,et al.  Comparison of a disease-specific and a generic severity of illness measure for patients with community-acquired pneumonia , 1995, Journal of General Internal Medicine.

[100]  M. Leinonen,et al.  Etiology and treatment of community-acquired pneumonia in ambulatory children. , 1999, The Pediatric infectious disease journal.

[101]  C. Hart,et al.  Clinical predictors of hypoxaemia in children with pneumonia. , 1998, Annals of tropical paediatrics.

[102]  M. Harper,et al.  Clinical predictors of occult pneumonia in the febrile child. , 2007, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[103]  F. Harrell,et al.  Accuracy of the clinical examination in detecting hypoxemia in infants with respiratory illness. , 1994, The Journal of pediatrics.

[104]  D. Nadal,et al.  Community-acquired pneumonia in children due to Mycoplasma pneumoniae: diagnostic performance of a seminested 16S rDNA-PCR. , 2001, Diagnostic microbiology and infectious disease.

[105]  G. Noel,et al.  Comparative Study of Levofloxacin in the Treatment of Children With Community-Acquired Pneumonia , 2007, The Pediatric infectious disease journal.

[106]  J. Bradley,et al.  Outpatient therapy of serious pediatric infections with ceftriaxone. , 1988, The Pediatric infectious disease journal.

[107]  C. Litwin,et al.  Rapid detection of Mycoplasma pneumoniae IgM antibodies in pediatric patients using ImmunoCard Mycoplasma compared to conventional enzyme immunoassays , 2004, European Journal of Clinical Microbiology and Infectious Diseases.

[108]  G. Guyatt,et al.  GRADE: an emerging consensus on rating quality of evidence and strength of recommendations , 2008, BMJ : British Medical Journal.

[109]  O. Ruuskanen,et al.  Pneumolysin polymerase chain reaction for diagnosis of pneumococcal pneumonia and empyema in children , 2006, European Journal of Clinical Microbiology and Infectious Diseases.

[110]  S. Deresinski.  Vancomycin heteroresistance and methicillin-resistant Staphylococcus aureus. , 2009, The Journal of infectious diseases.

[111]  M. Harper,et al.  Assessing Quality Indicators for Pediatric Community-Acquired Pneumonia , 2009, American journal of medical quality : the official journal of the American College of Medical Quality.

[112]  S. Weingart,et al.  Clinical policy: critical issues in the management of adult patients presenting to the emergency department with community-acquired pneumonia. , 2009, Annals of emergency medicine.

[113]  W. Lim,et al.  Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study , 2003, Thorax.

[114]  Inger,et al.  A prediction rule to identify low-risk patients with community-acquired pneumonia. , 1997, The New England journal of medicine.

[115]  R. B. Himelman,et al.  The prognostic value of loculations in parapneumonic pleural effusions. , 1986, Chest.

[116]  C. Byington,et al.  Seasonal Invasive Pneumococcal Disease in Children: Role of Preceding Respiratory Viral Infection , 2008, Pediatrics.

[117]  E. Wald,et al.  Roentgenographic follow-up of acute pneumonia in children. , 1979, Pediatrics.

[118]  M. Harper,et al.  Radiographic Pneumonia in Young, Highly Febrile Children With Leukocytosis Before and After Universal Conjugate Pneumococcal Vaccination , 2009, Pediatric emergency care.

[119]  Steven Black,et al.  Decline in invasive pneumococcal disease after the introduction of protein-polysaccharide conjugate vaccine. , 2003, The Journal of pediatrics.

[120]  W. Schaffner,et al.  Influenza-Associated Pneumonia in Children Hospitalized With Laboratory-Confirmed Influenza, 2003–2008 , 2010, The Pediatric infectious disease journal.

[121]  J. Bartlett,et al.  Infectious Diseases Society of America/American Thoracic Society Consensus Guidelines on the Management of Community-Acquired Pneumonia in Adults , 2007, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[122]  R. Lynfield,et al.  Community-Associated Methicillin-Resistant Staphylococcus aureus: Trends in Case and Isolate Characteristics from Six Years of Prospective Surveillance , 2009, Public health reports.

[123]  C. Hall,et al.  The Role of Immunoprophylaxis in the Reduction of Disease Attributable to Respiratory Syncytial Virus , 2009, Pediatrics.

[124]  E. Picard,et al.  Predictive Factors of Morbidity in Childhood Parapneumonic Effusion-associated Pneumonia: A Retrospective Study , 2010, The Pediatric infectious disease journal.

[125]  R. Davis,et al.  Influenza and the rates of hospitalization for respiratory disease among infants and young children. , 2000, The New England journal of medicine.

[126]  S. Kaplan,et al.  Staphylococcus aureus: a community pathogen. , 2009, Infectious disease clinics of North America.

[127]  C. Byington,et al.  Pneumococcal necrotizing pneumonia in Utah: Does serotype matter? (Clinical Infectious Disease (May 1, 2008) 46 (1346-1352)) , 2008 .

[128]  D. Fleming,et al.  Surveillance for pediatric deaths associated with 2009 pandemic influenza A (H1N1) virus infection - United States, April-August 2009. , 2009, MMWR. Morbidity and mortality weekly report.

[129]  Lucia H. Lee,et al.  Modified Recommendations for Use of Palivizumab for Prevention of Respiratory Syncytial Virus Infections , 2009, Pediatrics.

[130]  D. Brewster.  FEIGIN & CHERRY'S TEXTBOOK OF PEDIATRIC INFECTIOUS DISEASES , 2011 .

[131]  G. Losonsky,et al.  Motavizumab for Prophylaxis of Respiratory Syncytial Virus in High-Risk Children: A Noninferiority Trial , 2010, Pediatrics.

[132]  C A Britton,et al.  Interobserver reliability of the chest radiograph in community-acquired pneumonia. PORT Investigators. , 1996, Chest.

[133]  K. Sunakawa,et al.  A comparative clinical study of macrolide-sensitive and macrolide-resistant Mycoplasma pneumoniae infections in pediatric patients , 2009, Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy.

[134]  W. Neblett,et al.  Implications of Early Sonographic Evaluation of Parapneumonic Effusions in Children With Pneumonia , 1998, Pediatrics.

[135]  M. Hammerschlag.  Pneumonia due to Chlamydia pneumoniae in children: Epidemiology, diagnosis, and treatment , 2003, Pediatric pulmonology.

[136]  S. Esposito,et al.  Effect of a rapid influenza diagnosis , 2003, Archives of disease in childhood.

[137]  M. Molyneux,et al.  Blood culture collection technique and pneumococcal surveillance in Malawi during the four year period 2003–2006: an observational study , 2008, BMC infectious diseases.

[138]  T. Cherian,et al.  Burden of disease caused by Streptococcus pneumoniae in children younger than 5 years: global estimates , 2009, The Lancet.

[139]  G. Mccracken.  Etiology and treatment of pneumonia , 2000, The Pediatric Infectious Disease Journal.

[140]  M. Fine,et al.  Do pulmonary radiographic findings at presentation predict mortality in patients with community-acquired pneumonia? , 1996, Archives of internal medicine.

[141]  Gina Soriya,et al.  Improved clinical outcomes with utilization of a community-acquired pneumonia guideline , 2007 .

[142]  D. Zurakowski,et al.  Outcomes of primary image-guided drainage of parapneumonic effusions in children. , 2002, Pediatrics.

[143]  G. Sebag,et al.  Blind protected specimen brush and bronchoalveolar lavage in ventilated children. , 1999, Critical care medicine.

[144]  T. Uyeki.  Diagnostic testing for 2009 pandemic influenza A (H1N1) virus infection in hospitalized patients. , 2009, The New England journal of medicine.

[145]  B. Marmion.  Eaton agent--science and scientific acceptance: a historical commentary. , 1990, Reviews of infectious diseases.

[146]  M. Frosch,et al.  Detection of Mycoplasma pneumoniae by polymerase chain reaction and nonradioactive hybridization in microtiter plates , 1993, Journal of clinical microbiology.

[147]  T. Marrie,et al.  The contribution of blood cultures to the clinical management of adult patients admitted to the hospital with community-acquired pneumonia: a prospective observational study. , 2003, Chest.

[148]  T. Klassen,et al.  A Systematic Review on the Diagnosis of Pediatric Bacterial Pneumonia: When Gold Is Bronze , 2010, PloS one.

[149]  O. Ruuskanen,et al.  Serum procalcitonin, C‐reactive protein and interleukin‐6 for distinguishing bacterial and viral pneumonia in children , 2000, The Pediatric infectious disease journal.

[150]  W. Schaffner,et al.  Effect of introduction of the pneumococcal conjugate vaccine on drug-resistant Streptococcus pneumoniae. , 2006, The New England journal of medicine.

[151]  J. Laberge,et al.  Empyema thoracis in children: a 26-year review of the Montreal Children's Hospital experience. , 1997, Journal of pediatric surgery.

[152]  M. Bueno Campaña,et al.  [Is the incidence of parapneumonic pleural effusion increasing?]. , 2008, Anales de pediatria.

[153]  K. Harrington,et al.  Impact of Rapid Leukodepletion on the Outcome of Severe Clinical Pertussis in Young Infants , 2010, Pediatrics.

[154]  C. Byington,et al.  Molecular Analysis Improves Pathogen Identification and Epidemiologic Study of Pediatric Parapneumonic Empyema , 2011, The Pediatric infectious disease journal.

[155]  A. Bilbao,et al.  Validation of a predictive rule for the management of community-acquired pneumonia , 2006, European Respiratory Journal.

[156]  John S. Bradley,et al.  Practice Guidelines for Outpatient Parenteral Antimicrobial Therapy , 2004 .

[157]  C. Rodrigo,et al.  Procalcitonin, C-reactive protein and leukocyte count in children with lower respiratory tract infection , 2003, The Pediatric infectious disease journal.

[158]  M. Leinonen,et al.  White blood cells, C-reactive protein and erythrocyte sedimentation rate in pneumococcal pneumonia in children. , 1997, The European respiratory journal.

[159]  J. Casal,et al.  Usefulness of pneumococcal antigen detection in pleural effusion for the rapid diagnosis of infection by Streptococcus pneumoniae , 2010, European Journal of Pediatrics.

[160]  C. C. Chidi,et al.  Lung abscess: A study of the results of treatment based on 90 consecutive cases , 1974 .

[161]  L. Brown,et al.  Pulse oximetry in discharge decision-making: a survey of emergency physicians. , 2002, CJEM.

[162]  R. Lorenzo,et al.  Lung abscesses in children: diagnostic and therapeutic needle aspiration. , 1985, Radiology.

[163]  Cynthia A. Britton,et al.  Clinical Investigations: InfectionInterobserver Reliability of the Chest Radiograph in Community-Acquired Pneumonia , 1996 .

[164]  A. Cataneo,et al.  Complicated pneumonias with empyema and/or pneumatocele in children , 2006, Pediatric Surgery International.

[165]  J. Jensen,et al.  Detection of Mycoplasma pneumoniae in simulated clinical samples by Polymerase Chain Reaction , 1989, APMIS : acta pathologica, microbiologica, et immunologica Scandinavica.

[166]  L. Tang,et al.  Fiberoptic Bronchoscopy in Neonatal and Pediatric Intensive Care Units: A 5-Year Experience , 2009, Medical Principles and Practice.

[167]  Mónica Pujadas,et al.  Pneumococcal pneumonia in hospitalized Uruguayan children and potential prevention with different vaccine formulations. , 2008, The Journal of pediatrics.

[168]  S. Kaplan,et al.  Clinical characteristics and outcome of children with pneumonia attributable to penicillin-susceptible and penicillin-nonsusceptible Streptococcus pneumoniae. , 1998, Pediatrics.

[169]  F. Tubau,et al.  The effect of cephalosporin resistance on mortality in adult patients with nonmeningeal systemic pneumococcal infections. , 2002, The American journal of medicine.

[170]  A. Chang,et al.  Antibiotics for community-acquired lower respiratory tract infections secondary to Mycoplasma pneumoniae in children. , 2015, The Cochrane database of systematic reviews.

[171]  S. Remes,et al.  Serum procalcitonin concentrations in bacterial pneumonia in children: A negative result in primary healthcare settings , 2003, Pediatric pulmonology.

[172]  J. Modlin,et al.  Empiric antibiotics are justified for infants with respiratory syncytial virus lower respiratory tract infection presenting with respiratory failure: A prospective study and evidence review* , 2009, Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

[173]  U. Ruttimann,et al.  Objective assessment of changing mortality risks in pediatric intensive care unit patients , 1991, Critical care medicine.

[174]  J. Paton,et al.  Value of radiological follow up of childhood pneumonia. , 1993, BMJ.

[175]  J. Sung,et al.  Outcomes of adults hospitalised with severe influenza , 2010, Thorax.

[176]  P. Bijur,et al.  Limited usefulness of initial blood cultures in community acquired pneumonia. , 2004, Emergency medicine journal : EMJ.

[177]  P. Sheedy,et al.  Frequency of pleural effusions in mycoplasma and viral pneumonias. , 1970, The New England journal of medicine.

[178]  W. Ball,et al.  Percutaneous drainage of chest abscesses in children. , 1989, Radiology.

[179]  M. Steinhoff,et al.  Clinical predictors of acute radiological pneumonia and hypoxaemia at high altitude. , 1994, Archives of disease in childhood.

[180]  M. Jacobs,et al.  Review of the spectrum and potency of orally administered cephalosporins and amoxicillin/clavulanate. , 2007, Diagnostic microbiology and infectious disease.

[181]  T. Cherian,et al.  Burden of disease caused by Haemophilus influenzae type b in children younger than 5 years: global estimates , 2009, The Lancet.

[182]  T. Marrie,et al.  Interobserver variability in the interpretation of chest roentgenograms of patients with possible pneumonia. , 1994, Archives of internal medicine.

[183]  D. Tibboel,et al.  Plasma Concentrations of Oseltamivir and Oseltamivir Carboxylate in Critically Ill Children on Extracorporeal Membrane Oxygenation Support , 2010, PloS one.

[184]  P. Succop,et al.  Persistent Abnormal Lung Function After Childhood Empyema , 2002, American journal of respiratory medicine : drugs, devices, and other interventions.

[185]  P. Heaton,et al.  The utility of chest radiography in the follow-up of pneumonia. , 1998, The New Zealand medical journal.

[186]  Z. Bhutta,et al.  Short-course versus long-course antibiotic therapy for non-severe community-acquired pneumonia in children aged 2 months to 59 months. , 2008, The Cochrane database of systematic reviews.

[187]  F. Khan,et al.  Is procalcitonin better than C‐reactive protein for early diagnosis of bacterial pneumonia in children? , 2010, Journal of clinical laboratory analysis.

[188]  O. Paltiel,et al.  Chest radiographs in the emergency department: is the radiologist really necessary? , 2003, Postgraduate medical journal.

[189]  Samir S. Shah,et al.  National Hospitalization Trends for Pediatric Pneumonia and Associated Complications , 2010, Pediatrics.

[190]  C. Byington,et al.  Recommendations for Prevention and Control of Influenza in Children, 2016–2017 , 2016, Pediatrics.

[191]  E. Castaldo,et al.  Severe Sepsis Attributable to Community-Associated Methicillin-Resistant Staphylococcus aureus: An Emerging Fatal Problem , 2007, The American surgeon.

[192]  Samir S. Shah,et al.  Adjunct Corticosteroids in Children Hospitalized With Community-Acquired Pneumonia , 2011, Pediatrics.

[193]  D. Greenberg,et al.  Complicated community acquired pneumonia in children prior to the introduction of the pneumococcal conjugated vaccine , 2009, Scandinavian journal of infectious diseases.

[194]  Jerome J. Schentag,et al.  Direct Costs in Patients Hospitalised with Community-Acquired Pneumonia After Non-Response to Outpatient Treatment with Macrolide Antibacterials in the US , 2012, PharmacoEconomics.

[195]  D. Greenberg,et al.  Community-Acquired Pneumonia in Children: Quantifying the Burden on Patients and Their Families Including Decrease in Quality of Life , 2005, Pediatrics.

[196]  M. Campbell,et al.  Safety and efficacy of azithromycin in the treatment of community-acquired pneumonia in children. , 1998, The Pediatric infectious disease journal.

[197]  Alberto Medina,et al.  Predictive factors of non invasive ventilation failure in critically ill children: a prospective epidemiological study , 2009, Intensive Care Medicine.

[198]  C. Woods,et al.  Streptococcus pneumoniae Antigen Test Using Positive Blood Culture Bottles as an Alternative Method To Diagnose Pneumococcal Bacteremia , 2005, Journal of Clinical Microbiology.

[199]  C. Uiterwaal,et al.  Concurrent bacterial infection and prolonged mechanical ventilation in infants with respiratory syncytial virus lower respiratory tract disease , 2005, Intensive Care Medicine.

[200]  E F Mitchel,et al.  The effect of influenza on hospitalizations, outpatient visits, and courses of antibiotics in children. , 2000, The New England journal of medicine.

[201]  V. Sharma,et al.  Impact of Rapid Influenza Testing at Triage on Management of Febrile Infants and Young Children , 2006, Pediatric emergency care.

[202]  M. de Martino,et al.  Comparison of the effect of antibiotic treatment on the possibility of diagnosing invasive pneumococcal disease by culture or molecular methods: a prospective, observational study of children and adolescents with proven pneumococcal infection. , 2009, Clinical therapeutics.

[203]  C. Chiu,et al.  Clinical spectrum of tuberculous pleural effusion in children , 2007, Pediatrics international : official journal of the Japan Pediatric Society.

[204]  M. Harper,et al.  Pneumonia in Hospitalized Children , 2005, Pediatric Clinics of North America.

[205]  V. Novack,et al.  Disagreement in the interpretation of chest radiographs among specialists and clinical outcomes of patients hospitalized with suspected pneumonia. , 2006, European journal of internal medicine.

[206]  R. R. Shaw,et al.  Primary lung abscess. , 1964, The Journal of thoracic and cardiovascular surgery.

[207]  M. Lipsitch,et al.  Time from Illness Onset to Death, 1918 Influenza and Pneumococcal Pneumonia , 2009, Emerging infectious diseases.

[208]  R. Freeman,et al.  Clinical features, aetiology and outcome of empyema in children in the north east of England , 2004, Thorax.

[209]  John S. Brownstein,et al.  Age-related trends in the timeliness and prediction of medical visits, hospitalizations and deaths due to pneumonia and influenza, British Columbia, Canada, 1998-2004. , 2008, Vaccine.

[210]  R. Mcdonald,et al.  FIVE-FOLD INCREASE IN PEDIATRIC PARAPNEUMONIC EMPYEMA SINCE INTRODUCTION OF PNEUMOCOCCAL CONJUGATE VACCINE , 2008, The Pediatric infectious disease journal.

[211]  D. Goldmann,et al.  Empyema in children: clinical course and long-term follow-up. , 1984, Pediatrics.

[212]  K. Sunakawa,et al.  Comprehensive detection of causative pathogens using real-time PCR to diagnose pediatric community-acquired pneumonia , 2008, Journal of Infection and Chemotherapy.

[213]  R. Light.  Pleural diseases. , 1992, Disease-a-month : DM.

[214]  L. Ochoa,et al.  The changing face of pleural empyemas in children: epidemiology and management. , 2004, Pediatrics.

[215]  S. Kaplan,et al.  Severe Staphylococcal Sepsis in Adolescents in the Era of Community-Acquired Methicillin-Resistant Staphylococcus aureus , 2005, Pediatrics.

[216]  P. Surén,et al.  Community‐acquired pneumonia (CAP) in children in Oslo, Norway , 2008, Acta paediatrica.

[217]  G. Beauchamp,et al.  Optimizing oral medications for children. , 2008, Clinical therapeutics.

[218]  T. Similowski,et al.  Invasive and Noninvasive Strategies for Management of Suspected Ventilator-Associated Pneumonia , 2000, Annals of Internal Medicine.

[219]  R. Platt,et al.  Can we predict which children with clinically suspected pneumonia will have the presence of focal infiltrates on chest radiographs? , 2004, Pediatrics.

[220]  R. Leggiadro.  Bacterial Coinfections in Lung Tissue Specimens from Fatal Cases of 2009 Pandemic Influenza A (H1N1) – United States, May–August 2009 , 2010 .

[221]  E. Walsh,et al.  Impact of rapid diagnosis on management of adults hospitalized with influenza. , 2006, Archives of internal medicine.

[222]  T. Uyeki,et al.  Influenza estacional en adultos y niños—Diagnóstico, tratamiento, quimioprofilaxis y control de brotes institucionales: Guías de práctica clínica de la Sociedad de Enfermedades Infecciosas de Estados Unidos de América , 2009, Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America.

[223]  S. Madhi,et al.  Pneumococcal pneumonia and influenza: a deadly combination. , 2009, Vaccine.

[224]  S. Esposito,et al.  Evaluation of rapid assay for detection of Streptococcus pneumoniae urinary antigen among infants and young children with possible invasive pneumococcal disease. , 2004, The Pediatric infectious disease journal.

[225]  V. Foulongne,et al.  Human Bocavirus Infection in Children With Respiratory Tract Disease , 2008, The Pediatric infectious disease journal.

[226]  R. Vinci,et al.  An Analysis of Pediatric Blood Cultures in the Postpneumococcal Conjugate Vaccine Era in a Community Hospital Emergency Department , 2006, Pediatric emergency care.

[227]  E. Alpern,et al.  Occult bacteremia from a pediatric emergency department: current prevalence, time to detection, and outcome. , 2000, Pediatrics.

[228]  M. Neuman,et al.  Evaluation of a rapid urine antigen assay for the detection of invasive pneumococcal disease in children. , 2003, Pediatrics.

[229]  P. Berche,et al.  Microbiological diagnosis of empyema in children: comparative evaluations by culture, polymerase chain reaction, and pneumococcal antigen detection in pleural fluids. , 2006, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[230]  I. Balfour-Lynn,et al.  BTS guidelines for the management of pleural infection in children , 2005, Thorax.

[231]  Andrew Pavia,et al.  Impact of the Pneumococcal Conjugate Vaccine on Pneumococcal Parapneumonic Empyema , 2006, The Pediatric infectious disease journal.

[232]  D. Nadal,et al.  Rapid detection of Mycoplasma pneumoniae in clinical samples by real-time PCR. , 2000, Journal of microbiological methods.

[233]  J. Hedrick,et al.  Mycoplasma pneumoniae and Chlamydia pneumoniae in pediatric community-acquired pneumonia: comparative efficacy and safety of clarithromycin vs. erythromycin ethylsuccinate. , 1995, The Pediatric infectious disease journal.

[234]  S. Buckingham,et al.  Incidence and etiologies of complicated parapneumonic effusions in children, 1996 to 2001 , 2003, The Pediatric infectious disease journal.

[235]  S. Tsiodras,et al.  The impact on community acquired pneumonia empirical therapy of diagnostic bronchoscopic techniques , 2008, Scandinavian journal of infectious diseases.

[236]  D. Gilbert,et al.  Position paper: recommended design features of future clinical trials of antibacterial agents for community-acquired pneumonia. , 2008, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[237]  M. Prokop,et al.  Patterns of resolution of chest radiograph abnormalities in adults hospitalized with severe community-acquired pneumonia. , 2007, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[238]  V L Yu,et al.  Guidelines for the initial management of adults with community-acquired pneumonia: diagnosis, assessment of severity, and initial antimicrobial therapy. American Thoracic Society. Medical Section of the American Lung Association. , 1993 .

[239]  Stefan Gravenstein,et al.  Influenza estacional en adultos y niños—Diagnóstico, tratamiento, quimioprofilaxis y control de brotes institucionales: Guías de práctica clínica de la Sociedad de Enfermedades Infecciosas de Estados Unidos de América , 2009, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[240]  E. Picard,et al.  Clinical characteristics and outcome of complicated pneumococcal pneumonia in a pediatric population , 2006, Pediatric pulmonology.

[241]  S. Fishman,et al.  Lung abscess versus necrotizing pneumonia: implications for interventional therapy , 1999, Pediatric Radiology.

[242]  Christopher P Gorton,et al.  Wide Geographic Variation Between Pennsylvania Counties in the Population Rates of Hospital Admissions for Pneumonia Among Children With and Without Comorbid Chronic Conditions , 2006, Pediatrics.

[243]  F. Olavarría,et al.  Está aumentando la incidencia de derrames pleurales paraneumónicos , 2008 .

[244]  Jiaquan Xu,et al.  Deaths: final data for 2006. , 2009, National vital statistics reports : from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System.

[245]  P. Vanhems,et al.  Factors predicting mortality in necrotizing community-acquired pneumonia caused by Staphylococcus aureus containing Panton-Valentine leukocidin. , 2007, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[246]  P. Byass,et al.  ASSESSMENT OF CLINICAL CRITERIA FOR IDENTIFICATION OF SEVERE ACUTE LOWER RESPIRATORY TRACT INFECTIONS IN CHILDREN , 1989, The Lancet.

[247]  W. Mogabgab,et al.  Therapeutic effect of erythromycin on Mycoplasma pneumoniae pneumonia. , 1965, Antimicrobial agents and chemotherapy.

[248]  F. W. Denny,et al.  Epidemiologic patterns of acute lower respiratory disease of children in a pediatric group practice. , 1971, The Journal of pediatrics.

[249]  B. Chicoine.  Recurrent pneumonia , 2000, Archives of disease in childhood.

[250]  C. Byington,et al.  Development and Validation of a Risk Score for Predicting Hospitalization in Children With Influenza Virus Infection , 2009, Pediatric emergency care.

[251]  J. Bradley,et al.  Pharmacokinetics, Pharmacodynamics, and Monte Carlo Simulation: Selecting the Best Antimicrobial Dose to Treat an Infection , 2010, The Pediatric infectious disease journal.

[252]  S. Dowell,et al.  Mortality from pneumonia in children in the United States, 1939 through 1996. , 2000, The New England journal of medicine.

[253]  K. Kim,et al.  Clinical characteristics of children with complicated pneumonia caused by Streptococcus pneumoniae. , 2002, Pediatrics.

[254]  R. Tasker,et al.  Acute hypoxemic respiratory failure in children: case mix and the utility of respiratory severity indices , 1998, Intensive Care Medicine.

[255]  A. Schuchat,et al.  Decline in invasive pneumococcal disease after the introduction of protein-polysaccharide conjugate vaccine. , 2003, The New England journal of medicine.

[256]  R. Cohen,et al.  Study of the acceptability of antibiotic syrups, suspensions, and oral solutions prescribed to pediatric outpatients , 2009, European Journal of Pediatrics.

[257]  I. Wacogne,et al.  Are follow up chest x ray examinations helpful in the management of children recovering from pneumonia? , 2003, Archives of disease in childhood.

[258]  J. Clark,et al.  Children with pneumonia: how do they present and how are they managed? , 2007, Archives of Disease in Childhood.

[259]  C. Luaces,et al.  Pediatric parapneumonic pleural effusion: Epidemiology, clinical characteristics, and microbiological diagnosis , 2009, Pediatric pulmonology.

[260]  Margo J. Anderson,et al.  The Census , 1921, The Hospital.

[261]  Mike K. Chen,et al.  Position paper on video-assisted thoracoscopic surgery as treatment of pediatric empyema. , 2009, Journal of pediatric surgery.

[262]  F. Blasi,et al.  Chlamydophila pneumoniae. , 2009, Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases.

[263]  H. Peltola,et al.  Simplified treatment of acute staphylococcal osteomyelitis of childhood. The Finnish Study Group. , 1997, Pediatrics.

[264]  J. Benito-Fernández,et al.  Impact of Rapid Viral Testing for Influenza A and B Viruses on Management of Febrile Infants Without Signs of Focal Infection , 2006, The Pediatric infectious disease journal.

[265]  P. Jeena,et al.  A clinical tool to predict failed response to therapy in children with severe pneumonia , 2009, Pediatric pulmonology.

[266]  J. Graf,et al.  Pediatric tracheostomies: A recent experience from one academic center* , 2008, Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

[267]  O. Ramilo,et al.  Viral Coinfections in Children With Invasive Pneumococcal Disease , 2009, The Pediatric infectious disease journal.

[268]  W. Puppe,et al.  Population-Based Incidence of Severe Pneumonia in Children in Kiel, Germany , 2005, Klinische Padiatrie.

[269]  R. Connors,et al.  Therapy of Parapneumonic Effusions in Children: Video-Assisted Thoracoscopic Surgery Versus Conventional Thoracostomy Drainage , 2006, Pediatrics.

[270]  F. Shann,et al.  Clinical signs that predict death in children with severe pneumonia , 1989, The Pediatric infectious disease journal.

[271]  R. Peeling,et al.  Standardizing Chlamydia pneumoniae assays: recommendations from the Centers for Disease Control and Prevention (USA) and the Laboratory Centre for Disease Control (Canada). , 2001, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[272]  J. Coste,et al.  Procalcitonin in children admitted to hospital with community acquired pneumonia , 2001, Archives of disease in childhood.

[273]  Richard N. Shiffman,et al.  Diagnosis and management of bronchiolitis. , 2006, Pediatrics.

[274]  C. Byington,et al.  Association of 2009 Pandemic Influenza A (H1N1) Infection and Increased Hospitalization With Parapneumonic Empyema in Children in Utah , 2010, The Pediatric infectious disease journal.

[275]  C. Byington,et al.  Pneumococcal necrotizing pneumonia in Utah: does serotype matter? , 2006, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[276]  C. Byington,et al.  The effect of rapid respiratory viral diagnostic testing on antibiotic use in a children's hospital. , 2002, Archives of pediatrics & adolescent medicine.

[277]  M. Harper,et al.  Occult pneumonias: empiric chest radiographs in febrile children with leukocytosis. , 1999, Annals of emergency medicine.

[278]  E. Zell,et al.  Decline of childhood Haemophilus influenzae type b (Hib) disease in the Hib vaccine era. , 1993, JAMA.

[279]  L. Finelli,et al.  Surveillance for pediatric deaths associated with 2009 pandemic influenza A (H1N1) virus infection - United States, April-August 2009. , 2009 .

[280]  Lawrence Copelovitch,et al.  Streptococcus pneumoniae–Associated Hemolytic Uremic Syndrome: Classification and the Emergence of Serotype 19A , 2010, Pediatrics.

[281]  B. Yakubu,et al.  Comparison of a DNA based PCR method with conventional methods for the detection of M. tuberculosis in Jos, Nigeria. , 2009, Journal of infection in developing countries.

[282]  A. Esteban,et al.  Critically ill infants and children with influenza A (H1N1) in pediatric intensive care units in Argentina , 2010, Intensive Care Medicine.

[283]  O. Ruuskanen,et al.  Radiographic follow‐up of pneumonia in children , 2005, Pediatric pulmonology.

[284]  J. M. Porcel,et al.  Parapneumonic Effusions and Empyema , 1985, Medicina clinica.

[285]  Glenn Flores,et al.  Keeping children out of hospitals: parents' and physicians' perspectives on how pediatric hospitalizations for ambulatory care-sensitive conditions can be avoided. , 2003, Pediatrics.

[286]  P. Seddon,et al.  Management of thoracic empyema in childhood: does the pleural thickening matter? , 2003, Archives of disease in childhood.

[287]  Practice Guidelines for Outpatient Parenteral Antimicrobial Therapy , 2004 .

[288]  R. Gibson,et al.  Lung function in children following empyema. , 1990, American journal of diseases of children.

[289]  Marilyn J. Field,et al.  COMMITTEE TO ADVISE THE PUBLIC HEALTH SERVICE ON CLINICAL PRACTICE GUIDELINES , 1990 .

[290]  M. Xhignesse,et al.  Prevalence of pneumonia in children under 12 years of age who undergo abdominal radiography in the emergency department. , 2007, CJEM.

[291]  L. Grossman,et al.  Clinical, laboratory, and radiological information in the diagnosis of pneumonia in children. , 1988, Annals of emergency medicine.

[292]  Licensure of a 13-valent pneumococcal conjugate vaccine (PCV13) and recommendations for use among children - Advisory Committee on Immunization Practices (ACIP), 2010. , 2010, MMWR. Morbidity and mortality weekly report.

[293]  C. Bridges,et al.  The underrecognized burden of influenza in young children. , 2006, The New England journal of medicine.

[294]  M. English,et al.  In children aged 2-59 months with pneumonia, which clinical signs best predict hypoxaemia? , 2006, Journal of tropical pediatrics.

[295]  J. Stockman.  Hemolytic Uremic Syndrome Associated with Invasive Pneumococcal Disease: The United Kingdom Experience , 2009 .

[296]  R. Chanock,et al.  Eaton agent pneumonia. , 1961, Journal of the American Medical Association (JAMA).

[297]  M. A. Jackson,et al.  Thoracoscopic decortication vs tube thoracostomy with fibrinolysis for empyema in children: a prospective, randomized trial. , 2009, Journal of pediatric surgery.

[298]  A. Simon,et al.  Respiratory syncytial virus infection in children admitted to hospital but ventilated mechanically for other reasons , 2009, Journal of medical virology.

[299]  E. Johansson,et al.  Pneumonia: the leading killer of children , 2006, The Lancet.

[300]  G. Stickler,et al.  Problems in the Clinical and Roentgenographic Diagnosis of Pneumonia in Young Children , 1984, Clinical pediatrics.

[301]  E. Lewis,et al.  Effectiveness of heptavalent pneumococcal conjugate vaccine in children younger than five years of age for prevention of pneumonia , 2002, The Pediatric infectious disease journal.

[302]  K. Edwards,et al.  Parapneumonic empyema in children: decortication hastens recovery in patients with severe pleural infections. , 1991, The Pediatric infectious disease journal.

[303]  R. Selvarangan,et al.  Susceptibilities of Haemophilus influenzae, Streptococcus pneumoniae, including serotype 19A, and Moraxella catarrhalis paediatric isolates from 2005 to 2007 to commonly used antibiotics. , 2009, The Journal of antimicrobial chemotherapy.

[304]  Adrienne G. Randolph,et al.  Risk of Bacterial Infection in Previously Healthy Respiratory Syncytial Virus-Infected Young Children Admitted to the Intensive Care Unit , 2004, The Pediatric infectious disease journal.

[305]  F. Gleeson,et al.  Guidelines for radiologically guided lung biopsy , 2003, Thorax.

[306]  Rapid Influenza Antigen Test for Diagnosis of Pandemic (H1N1) 2009 , 2010, Emerging Infectious Diseases.

[307]  J. S. St. Sauver,et al.  Effectiveness of inactivated influenza vaccine in children less than 5 years of age over multiple influenza seasons: a case-control study. , 2009, Vaccine.

[308]  L. Rubin,et al.  Incidence of occult bacteremia among highly febrile young children in the era of the pneumococcal conjugate vaccine: a study from a Children's Hospital Emergency Department and Urgent Care Center. , 2004, Archives of pediatrics & adolescent medicine.

[309]  E. Wang,et al.  A practical guide for the diagnosis and treatment of pediatric pneumonia. , 1997, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[310]  P. Hotez,et al.  Feigin & Cherry's textbook of pediatric infectious diseases , 2009 .

[311]  C. Byington,et al.  Epidemiology of Streptococcus pneumoniae-Induced Hemolytic Uremic Syndrome in Utah Children , 2010, The Pediatric infectious disease journal.

[312]  C. Dassa,et al.  Reproducibility of blind protected bronchoalveolar lavage in mechanically ventilated children. , 2002, American journal of respiratory and critical care medicine.

[313]  S. Shemie,et al.  Open lung biopsy in children with respiratory failure , 2001, Critical care medicine.

[314]  O. Kremp,et al.  Assessment of a rapid urinary antigen detection by an immunochromatographic test for diagnosis of pneumococcal infection in children. , 2006, Diagnostic microbiology and infectious disease.

[315]  W. Schaffner,et al.  Sustained reductions in invasive pneumococcal disease in the era of conjugate vaccine. , 2010, The Journal of infectious diseases.

[316]  C. Glaser,et al.  Severe Pediatric Influenza in California, 2003–2005: Implications for Immunization Recommendations , 2006, Pediatrics.

[317]  K. Mcintosh.  Community-acquired pneumonia in children. , 2002, The New England journal of medicine.

[318]  I. Iqbal,et al.  Comparison of standard versus double dose of amoxicillin in the treatment of non-severe pneumonia in children aged 2–59 months: a multi-centre, double blind, randomised controlled trial in Pakistan , 2006, Archives of Disease in Childhood.

[319]  T. British.  BTS Guidelines for the Management of Community Acquired Pneumonia in Childhood , 2002 .

[320]  K. Poehling,et al.  National Impact of Universal Childhood Immunization With Pneumococcal Conjugate Vaccine on Outpatient Medical Care Visits in the United States , 2006, Pediatrics.

[321]  N Taub,et al.  An assessment of inter-observer agreement and accuracy when reporting plain radiographs. , 1997, Clinical radiology.

[322]  Donald M Yealy,et al.  Prospective comparison of three validated prediction rules for prognosis in community-acquired pneumonia. , 2005, The American journal of medicine.

[323]  D. Fisman,et al.  Laboratory-based evaluation of legionellosis epidemiology in Ontario, Canada, 1978 to 2006 , 2009, BMC infectious diseases.

[324]  K. O'Brien,et al.  Severe pneumococcal pneumonia in previously healthy children: the role of preceding influenza infection. , 2000, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[325]  A. Hoberman,et al.  Bacteriologic and clinical efficacy of high dose amoxicillin/clavulanate in children with acute otitis media , 2001, The Pediatric infectious disease journal.

[326]  L. Kaiser,et al.  Community-acquired pneumonia: causes of treatment failure in patients enrolled in clinical trials. , 2003, Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases.

[327]  Donald R Graham,et al.  Practice guidelines for outpatient parenteral antimicrobial therapy. IDSA guidelines. , 2004, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[328]  G. Mccracken,et al.  Epidemiology and Evolution of Invasive Pneumococcal Disease Caused by Multidrug Resistant Serotypes of 19A in the 8 Years After Implementation of Pneumococcal Conjugate Vaccine Immunization in Dallas, Texas , 2009, The Pediatric infectious disease journal.

[329]  G. Feola,et al.  Current treatment of pediatric empyema. , 2004, Seminars in thoracic and cardiovascular surgery.

[330]  O. Ruuskanen,et al.  Development of parapneumonic empyema in children , 2007, Acta paediatrica.

[331]  G. A. Smith,et al.  Utility of blood cultures in pediatric patients found to have pneumonia in the emergency department. , 1996, Annals of emergency medicine.

[332]  T. A. Tuan,et al.  Brief Hospitalization and Pulse Oximetry for Predicting Amoxicillin Treatment Failure in Children with Severe Pneumonia , 2006, Pediatrics.

[333]  J. Carlin,et al.  Standardized interpretation of paediatric chest radiographs for the diagnosis of pneumonia in epidemiological studies. , 2005, Bulletin of the World Health Organization.

[334]  J E Heffner,et al.  Pleural fluid chemical analysis in parapneumonic effusions. A meta-analysis. , 1995, American journal of respiratory and critical care medicine.

[335]  B. Bender,et al.  Patient-identified barriers to asthma treatment adherence: responses to interviews, focus groups, and questionnaires. , 2005, Immunology and allergy clinics of North America.

[336]  R. Glazier,et al.  Relationship between social inequalities and ambulatory care-sensitive hospitalizations persists for up to 9 years among children born in a major Canadian urban center. , 2007, Ambulatory pediatrics : the official journal of the Ambulatory Pediatric Association.

[337]  G. Haq.  Bacterial pneumonias. , 1984, JPMA. The Journal of the Pakistan Medical Association.

[338]  J. Langley,et al.  Empyema associated with community-acquired pneumonia: A Pediatric Investigator's Collaborative Network on Infections in Canada (PICNIC) study , 2008, BMC infectious diseases.

[339]  Q. Doan,et al.  A randomized, controlled trial of the impact of early and rapid diagnosis of viral infections in children brought to an emergency department with febrile respiratory tract illnesses. , 2009, The Journal of pediatrics.

[340]  B. Littenberg,et al.  Medical and surgical treatment of parapneumonic effusions : an evidence-based guideline. , 2000, Chest.

[341]  M. Neuman,et al.  Clinical Predictors of Pneumonia Among Children With Wheezing , 2009, Pediatrics.

[342]  K. O'Brien,et al.  Impact of azithromycin on oropharyngeal carriage of group A Streptococcus and nasopharyngeal carriage of macrolide-resistant Streptococcus pneumoniae. , 2000, The Pediatric infectious disease journal.

[343]  S. Harigopal,et al.  High incidence of pulmonary bacterial co-infection in children with severe respiratory syncytial virus (RSV) bronchiolitis , 2006, Thorax.

[344]  K. Poehling,et al.  The burden of respiratory syncytial virus infection in young children. , 2009, The New England journal of medicine.

[345]  G. Swingler,et al.  Chest radiograph in acute respiratory infections. , 2009, The Cochrane database of systematic reviews.