Pneumonia.

Pneumonia is the leading cause of mortality and a common cause of morbidity in children below five years of age. Commonly, pneumonia is caused by bacterial agents. The diagnosis of pneumonia is usually made on clinical features. A child with tachypnea with no chest in-drawing or difficulty in feeding is labeled as pneumonia. Presence of chest in-drawing, difficulty in speech, feeding or cyanosis classifies a child as suffering from severe or very severe pneumonia. Factors that may help in selection of appropriate antibiotics include: knowledge of etiological agents, sensitivity of pathogens to antibiotics, severity of the disease, immune status, nutritional status, previous antimicrobial usages, history of hospitalization, duration of illness, associated complications and cost and safety of antibiotics. For selection of antibiotics pneumonia can be classified in two major categories (a) community acquired, without risk factors, and (b) pneumonia with risk factors. Both these can be further classified as non severe and severe illness. A community acquired pneumonia in a child between 2 months -60 months without risk factors for resistant or atypical organism may be treated with amoxicillin. The alternative to amoxicillin includes oral cephalosporins and cotrimoxazole. In pneumonia with presence of risk factors the antibiotics are decided on basis of individual patients characteristics. A child with non-severe pneumonia should be treated with oral cefuroxime or amoxicillin clavulinic acid for a period of 7-14 days.