Shann F
Intensive Care Unit, Royal Children's Hospital, Parkville, Victoria, Australia.
Clin Infect Dis. 1995 Dec;21 Suppl 3:S218-25. doi: 10.1093/clind/21.supplement_3.s218.
Pneumonia kills about 3 million children every year in developing countries, and it is now clear that most fatal pneumonia is caused by Haemophilus influenzae or Streptococcus pneumoniae. To reduce mortality associated with pneumonia, the World Health Organization has developed guidelines for the treatment of children in developing countries who have cough or difficulty breathing: children without tachypnea or chest indrawing do not need antibiotic therapy; children with tachypnea but no chest indrawing should have antibiotic therapy at home; and children with chest indrawing should be admitted to the hospital for intramuscular injections of benzylpenicillin or chloramphenicol. Universal application of these guidelines would save the lives of approximately 600,000 children every year. Other important issues are oxygen therapy, fluid restriction, limitation of the use of acetaminophen, pneumonia in neonates, and the emergence of antibiotic resistance. There is an urgent need for vaccines that protect infants against infection with S. pneumoniae and all strains of H. influenzae, including nonserotypeable strains.
在发展中国家，肺炎每年导致约300万儿童死亡，目前很明显，大多数致命性肺炎是由流感嗜血杆菌或肺炎链球菌引起的。为降低与肺炎相关的死亡率，世界卫生组织制定了针对发展中国家咳嗽或呼吸困难儿童的治疗指南：无呼吸急促或胸凹陷的儿童无需抗生素治疗；有呼吸急促但无胸凹陷的儿童应在家接受抗生素治疗；有胸凹陷的儿童应住院接受肌内注射苄青霉素或氯霉素治疗。普遍应用这些指南每年将挽救约60万名儿童的生命。其他重要问题包括氧疗、液体限制、对乙酰氨基酚的使用限制、新生儿肺炎以及抗生素耐药性的出现。迫切需要能保护婴儿免受肺炎链球菌和所有流感嗜血杆菌菌株（包括不可分型菌株）感染的疫苗。
