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 3 Comparison of antimicrobial empiric therapy recommendations for children with community-acquired pneumonia across different European medical centres compared with the United States [13], United Kingdom [1] and World Health Organization [14] guidelines

Site of care	Empiric therapy
	Guideline			European study^a
	PIDS-IDSA	BTS	WHO
Outpatient
First-Line	Amoxicillin	Amoxicillin	Amoxicillin	Amoxicillin Clarithromycin Azithromycin
Second Line	Macrolides^b Azithromycin Clarithromycin Erythromycin	Macrolides^c Erythromycin Azithromycin Clarithromycin Co-amoxiclav^d Cefaclor Ceftriaxone	Not Specified	Cefuroxime Amoxicillin/Clavulanic ac.
Inpatient
First-line	Ampicillin Penicillin G	Amoxicillin	Ampicillin (or benzylpenicillin) and Gentamicin	Amoxicillin Ampicillin Benzyl penicillin Azithromycin
Second-Line	Cephalosporin^e ß-lactam^c Vancomycin or Clindomycin^f	Macrolides^c Co-amoxiclav Cefuroxime Cefotaxime Ceftriaxone	Gentamicin Cloxacillin Ceftriaxone	Amoxicillin/Clavulanic ac. Cefotaxime

PIDS-IDSA Pediatric Infectious Diseases Society and the Infectious Diseases Society of America, BTS British Thoracic Society, WHO World Health Organization
^aOnly drugs recommended in >30 % of the medical centres are shown, none of these drugs were recommended in >50 % of medical centres
^bFor atypical pathogens, preferred and alternative agents for specific pathogens are extensively listed in [4]
^cFor children in whom Mycoplasma pneumoniae and Chlamydophila pneumoniae are significant considerations
^dFor pneumonia associated with influenza
^eFor hospitalised infants and children who are not fully immunised
^fIn addition to ß-lactam therapy if Staphylococcus aureus suspected

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