Abstract
In March 2000, “Fundamentals for the diagnosis and treatment of communityacquired pneumonia in adults” was published by the Japan Respiratory Society.However, it was still necessary to study the subject in children.In March 2002, “Fundamentals of nosocomial pneumonia in adults” was also released.In this symposium, an outline of the guidelines on adult community-acquired pneumonia was given as an introduction.Guidelines for children should also be evidence-based, but, determination of the causative bacteria in pneumonia is a difficult problem.We performed a nationwide survey of pneumonia in which bacteria were detected in the blood, pleural fluid, or lung tissue at training hospitals for pediatricians.The number of patients available for research was only 137 in the first survey (1984-86), and the three major causative organisms were S. aureus>S. pneumoniae>H. influenzae. The second survey (1993 -94) showed that, S. aureus was decreased sharply, so S. pneumoniae>H. influenzaewere the two major causative organisms and this trend has continued recently.In addition to pretreatment blood culture and antigen detection, we recommend sputum culture as is done in adults.We expect that this symposium will contribute to the performance of antimicrobial therapy on the basis of appropriate microbiological diagnosis of childhood pneumonia.
