Paediatricians need to differentiate between bacterial and viral forms of community-acquired pneumonia (CAP) to plan an effective antibiotic strategy, S. K. Kabra, Professor, Paediatric Pulmonology Division, AIIMS, New Delhi, said on Sunday.
Delivering the XX Dr. M.S. Ramakrishnan Memorial Endowment Oration under the auspices of the CHILDS Trust Medical Research Foundation (CTMRF), Dr. Kabra said an effective antibiotic intervention was imperative to raise treatment efficacy, reduce costs and minimise drug resistance.
He cited studies to argue that a short course regimen with amoxicillin was as effective as the conventional five-day schedule in the treatment of non-severe pneumonia. Apart from its cost implications, the findings of these studies also indicated that the most important cause for treatment failure was non-compliance that is associated with a longer duration of treatment.
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It is estimated that bacterial infections account for 40-60 per cent of pneumonia and viruses for 40-44 per cent of the cases while atypical pathogens are the trigger for 10-20 per cent of the cases, Dr. Kabra said.
CAP is the biggest cause of death in children worldwide accounting for about 1.5 million children under five annually. It is particularly rampant in developing countries where the acute respiratory infection accounts for 151 of the 156 million global cases annually. India alone records 43 million cases a year, Dr. Kabra said.
While there were several methods to identify the pathogen responsible for pneumonia, none of the clinical features or laboratory values had the ideal sensitivity, specificity or predictive values.
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In the Indian scenario, the lack of a structured referral system and paediatric ICU facilities even in district hospitals pose a major challenge in the management of CAP, Dr. Kabra said.
In his key-note address, Satish Kumar, Chief of Field Office, UNICEF, Chennai, said teaching hospitals and medical institutions had an important role in achieving the Millennium Development Goals as five of the eight targets set for 2015 related to child health.
It is also important that a progressive State like Tamil Nadu set its own benchmarks in relation with national averages and strive towards achieving the MDGs with equity across the districts, he said.
S. Gunasekaran, president, Rotary Club of Madras, said the Rotary would work closely with the CHILDS Trust to deliver healthcare to children.
K. Mathangi Ramakrishnan, CTMRF chairperson, P. K. Doraiswamy, Chairman, Kanchi Kamakoti CHILDS Trust Hospital, V. M. Sundaram, former director and superintendent, and A. Andal, honorary medical director also participated.