Community-acquired pneumonia in children and 10-valent anti pneumococcal vaccination: update
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Abstract
Introduction: the incorporation of 10-valent pneumococcal conjugate vaccine to the Brazilian vaccination calendar in 2010, by the National Immunization Program, led to the reduction of pneumococcal diseases such as meningitis and community-acquired pneumonia, and colonization of the oropharynx and nasal mucosa by pneumococ cus (Streptococcus pneumoniae). Objective: to carry out a review study on etiology, clinical picture, complications, conduct and preventive measures of community-acquired pneumonia, and to discuss pneumococcus resistance to antibiotics. Data source: books, articles and guidelines considered relevant from the last 21 years, indexed in PubMed, Medline, Lilacs and SciELO databases, with the descriptors ‘pneumonia’, ‘child’ and ‘pneumococcal vaccines’ in the Portuguese, English and Spanish languages. Data synthesis: all cases of severe community-acquired pneumonia require hospitalization and, in general, the use of ampicillin or crystalline penicillin as the first choice. Amoxicillin is indicated for outpatient treatment at a dose of 50 mg/kg/day of 8 in 8 hours. National studies identified that one year after the introduction of the 10-valent pneumococcal conjugate vaccine in the public health network there was a reduction of hospitalizations of children by community-acquired pneumonia in Brazil. Conclusions: the treatment of community-acquired pneumonia is still a challenge and the establishment of a guideline can be useful, prioritizing penicillinand its derivatives, that are still the drugs of choice all over the world. The establishment of 10-valent pneumococcal conjugate vaccine in the immunization schedule led to a reduction in community-acquired pneumonia admissions and should be encouraged by the pediatrician.
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