Comparison between diagnosis and treatment of community-acquired pneumonia in children in various medical centres across Europe with the United States, United Kingdom and the World Health Organization guidelines

Table 1 Comparison of clinical signs and symptoms to determine community-acquired pneumonia (CAP) severity among different European medical centres compared with the United States [13], United Kingdom [1] and World Health Organization [14] guidelines

Sign or symptom	Guidelines			European study^a
Sign or symptom	PIDS-IDSA	BTS^b	WHO	European study^a
Tachypnoea	✓^c	✓	✓^c	✓
Chest recession/indrawing/retractions	✓	✓	✓	✓
Nasal flaring	✓			✓
Cough			✓^d	✓
Grunting	✓		✓^d
Apnoea	✓
Fever		✓		✓
Difficulty breathing/respiratory distress	✓		✓^d	✓
Low oxygen saturation	✓ (<90 %)	✓ (<92 %)	✓^d (<90 %)	✓ (<95 %)
Abdominal pain				✓
General danger signs (inability to drink, vomiting, lethargy, convulsions)			✓^d
Altered mental status	✓
Cyanosis			✓^d
Auscultation revealing absent breath sounds with a dull percussion note or crackles		✓	✓	✓

PIDS-IDSA Pediatric Infectious Diseases Society and the Infectious Diseases Society of America, BTS British Thoracic Society, WHO World Health Organization
^aIndications for hospitalisation, only when >50 % of medical centres reported using the parameter
^bRecommendations for bacterial pneumonia
^cRespiratory rate adjusted by age
^dSymptom of severe CAP

ISSN: 2200-6133