Community-Acquired Pneumonia in Children Under Five: Etiology, Diagnosis, and Evidence-Based Management Strategies
Keywords:
community-acquired pneumonia, pediatric, antibiotic therapy, etiology, vaccine, WHO guidelines, lower respiratory tract infection, prevention, managementAbstract
Community-acquired pneumonia (CAP) remains the single leading infectious cause of mortality in children under five years worldwide, accounting for approximately 740,000 deaths annually. This comprehensive review synthesizes current evidence on etiology, clinical diagnosis, and management of pediatric CAP. Streptococcus pneumoniae and respiratory syncytial virus are the predominant causative organisms across all age groups. WHO severity classification guides treatment selection, with oral high-dose amoxicillin (90 mg/kg/day) recommended for non-severe cases and intravenous ampicillin combined with gentamicin for severe disease. Emerging evidence supports adjunctive zinc supplementation in malnourished children. Pneumococcal conjugate vaccine (PCV13) and influenza vaccination have demonstrated significant reductions in CAP incidence. Point-of-care diagnostics, including pulse oximetry and C-reactive protein testing, improve risk stratification in resource-limited settings. Prevention through vaccination, breastfeeding promotion, and reduction of indoor air pollution represents the most cost-effective strategy. Optimized protocols integrating severity-based antibiotic selection substantially improve outcomes in low- and middle-income countries.
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