Boyd Kathleen
Pediatr Ann. 2017 Jul 1;46(7):e257-e261. doi: 10.3928/19382359-20170616-01.
Community-acquired pneumonia (CAP) is a common childhood infection and often a reason for inpatient admission, especially when a child is hypoxic or in respiratory distress. Despite advances in technology and diagnostics, it remains difficult to accurately differentiate bacterial CAP from a viral process. Most of the laboratory tests routinely done in inpatient medicine, such as complete blood counts and acute phase reactants, do little to differentiate a viral pneumonia from a bacterial pneumonia. Clinicians must rely heavily on the clinical presentation and decide whether to treat empirically with antibiotics. Guidelines published by the Infectious Disease Society of America in 2011 have helped clinicians standardize the diagnosis and treatment of CAP. The guidelines recommend relatively narrow-spectrum antibiotics, such as ampicillin or penicillin, as empiric coverage for the fully immunized child older than age 3 months who requires hospitalization for CAP. [Pediatr Ann. 2017;46(7):e257-e261.].
社区获得性肺炎（CAP）是一种常见的儿童感染性疾病，常常是住院的原因，尤其是当儿童出现缺氧或呼吸窘迫时。尽管技术和诊断方法有所进步，但准确区分细菌性CAP与病毒感染过程仍然困难。住院治疗中常规进行的大多数实验室检查，如全血细胞计数和急性期反应物检测，对于区分病毒性肺炎和细菌性肺炎作用不大。临床医生必须严重依赖临床表现，并决定是否经验性使用抗生素治疗。美国传染病学会2011年发布的指南有助于临床医生规范CAP的诊断和治疗。该指南推荐使用相对窄谱的抗生素，如氨苄西林或青霉素，作为对3个月以上因CAP需要住院治疗且已完全免疫的儿童的经验性用药。[《儿科年鉴》。2017年；46(7):e257 - e261。]
