Características clínico-epidemiológicas de la neumonía adquirida en la comunidad en niños menores de 6 años

Abstract

Introduction Acute respiratory infections are an important cause of consultations in primary care and hospitals. Most published epidemiological studies have analyzed pneumonia in hospitals and very few include information on primary care. Material and methods We performed a multicenter, prospective, epidemiological study in 17 primary care centers and four hospital pediatric emergency rooms. All children under 6 years of age with a clinical diagnosis of pneumonia were included. Results There were 311 patients with a mean age of 32.2 months. The incidence of community-acquired pneumonia was 3,600 cases/100,000 children/year under 6 years old in primary care centers. Of these, 136 were diagnosed in hospitals (43.7 %). The most common clinical signs and symptoms were fever (95.4 %), cough (94.4 %), tachypnea (58.2 %), and auscultation abnormalities (90.2 %). Antibiotic therapy was started in 298 patients (98 %). The most frequent antibiotic was amoxicillin-clavulanate (39.5 %), followed by cefuroxime (32.7 %) and clarithromycin (8.3 %). The most frequently isolated microorganism was respiratory syncytial virus followed by Streptococcus pneumoniae. Hospital admission was required in 15.6 % of patients. Only 24.6% of the patients had been vaccinated with the heptavalent pneumococcal conjugate vaccine and 12.7 % of the children with underlying respiratory diseases had been vaccinated with the influenza virus vaccine. Conclusions In our milieu, the diagnosis and treatment of community-acquired pneumonia is usually carried out in primary care and the incidence is high. Although most patients do not require hospitalization, etiological diagnosis of community-acquired pneumonia and optimal antibiotic therapy remain difficult goals to achieve.