PAEDIATRIC AND NEONATAL INFECTIONS: Edited by Paul T. HeathUnsolved problems in the approach to pediatric community-acquired pneumoniaEsposito, Susanna; Principi, Nicola Author Information Department of Maternal and Pediatric Sciences, Università degli Studi di Milano, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy Correspondence to Susanna Esposito, Department of Maternal and Pediatric Sciences, Università degli Studi di Milano, Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico, Via Commenda 9, 20122 Milano, Italy. Tel: +39 02 55032498; fax: +39 02 50320206; e-mail: [email protected] Current Opinion in Infectious Diseases: June 2012 - Volume 25 - Issue 3 - p 286-291 doi: 10.1097/QCO.0b013e328352b60c Buy Metrics Abstract Purpose of review This review discusses unsolved problems concerning pediatric community-acquired pneumonia (CAP) and identifies the areas of research that need to be developed. Recent findings Diagnosing pediatric CAP and the required hospitalization are difficult problems especially in the presence of mild signs and symptoms. It is frequently not possible to identify the cause of this disease, and this explains why antibiotics are unnecessarily prescribed in some cases. The treatment recommendations for severe CAP are better defined than those for mild and moderate CAP. Summary It is possible to prepare recommendations for most of the problems that emerge in severe cases of pediatric CAP even though its cause can also be difficult to identify. However, the recommended approach to mild or moderate cases is always based on mainly moderate or poor quality evidence. There is an urgent need for further studies aimed at defining first-line and second-line antibiotic therapy for mild and moderate CAP. In the absence of new data, it is necessary to be aware that a substantial number of patients will not be optimally treated. © 2012 Lippincott Williams & Wilkins, Inc.