Optimizing Antibiotic Stewardship in Pediatric Community-Acquired Pneumonia: Clinical Pathways, Outcomes, and Emerging Challenges
Keywords:
pediatric pneumonia, antimicrobial stewardship, clinical pathway, community-acquired pneumonia, antibiotic optimization, pediatric hospitalization, respiratory infection managementAbstract
Community-acquired pneumonia (CAP) remains one of the foremost causes of pediatric morbidity and hospitalization globally. Inappropriate antibiotic prescribing in this population not only prolongs hospital stays but accelerates antimicrobial resistance—a public health crisis of mounting concern. This article reviews the epidemiology, diagnostic approach, and contemporary management strategies for CAP in children aged three months to eighteen years. We examine evidence underpinning guideline-concordant narrow-spectrum antibiotic therapy, clinical pathway (CP) implementation, and the intravenous-to-oral antibiotic switch strategy. Comparative analysis demonstrates that structured antimicrobial stewardship interventions significantly increase narrow-spectrum antibiotic use and reduce broad-spectrum prescribing without compromising clinical outcomes. Results indicate that CP adoption is associated with reduced length of stay, earlier IV-to-oral switching, and shortened antibiotic courses. These findings underscore the urgent need for integrated, evidence-based protocols at regional hospitals in Central Asia and similar low-to-middle-income settings.
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