a Department of Paediatrics and Child Health, Faculty of Health Sciences , University of Cape Town and Red Cross War Memorial Children's Hospital , Cape Town , South Africa.
Expert Opin Pharmacother. 2019 Apr;20(5):595-608. doi: 10.1080/14656566.2018.1561864. Epub 2019 Jan 21.
Community-acquired pneumonia is a leading cause of morbidity and mortality amongst HIV-infected infants and children. Polymicrobial infection is common and, due to the difficulties in confirming the etiology of pneumonia, empiric broad-spectrum antimicrobial therapy is frequently used.
The author based this article on literature identified from PubMed. The author's search terms included: pneumonia, community-acquired pneumonia, HIV, children. The articles reviewed included original studies, recent review articles and current guidelines on the management of pneumonia in HIV-infected children. The microbiological etiology and the empiric and pathogen-specific antimicrobial therapy of community-acquired pneumonia in HIV-infected and HIV-exposed infants and children are also discussed.
There are many changing epidemiological factors impacting antimicrobial management of community-acquired pneumonia in the context of HIV infection in infants and children. These include vaccination strategies, antimicrobial prophylaxis, emerging drug-resistant pathogens, and recognition of the importance of viruses and tuberculosis in the etiology of community-acquired pneumonia. Further research is needed on optimal amtimicrobial management strategies in HIV-exposed uninfected children, and HIV-infected children receiving antiretroviral therapy.
社区获得性肺炎是导致 HIV 感染婴儿和儿童发病率和死亡率的主要原因。混合感染很常见，由于确定肺炎病因存在困难，因此经常使用经验性广谱抗菌治疗。
作者基于从 PubMed 中识别的文献撰写了这篇文章。作者的搜索词包括：肺炎、社区获得性肺炎、HIV、儿童。综述的文章包括原始研究、近期综述文章以及关于 HIV 感染儿童肺炎管理的现行指南。还讨论了 HIV 感染和 HIV 暴露婴儿和儿童中社区获得性肺炎的微生物病因以及经验性和针对病原体的抗菌治疗。
在 HIV 感染背景下，影响婴儿和儿童社区获得性肺炎抗菌管理的流行病因学因素有很多。这些因素包括疫苗接种策略、抗菌预防、新出现的耐药病原体以及对病毒和结核病在社区获得性肺炎病因学中的重要性的认识。在未感染 HIV 的 HIV 暴露儿童以及接受抗逆转录病毒治疗的 HIV 感染儿童中，需要进一步研究最佳抗菌管理策略。
