Pulmonary bacterial coinfection in infants and children with viral respiratory infection

Abstract

The true incidence of pulmonary bacterial coinfection in infants and children hospitalized with a viral respiratory infection is difficult to ascertain but can vary widely from under 1 to 44%. For the same patient group admitted to pediatric intensive care units and/or requiring ventilatory support, the evidence is more convincing, with reported incidences of 17–39%. Studies covering influenza and respiratory syncytial virus infection dominate the recent literature. Whether treatment (or ‘cover’) with antibiotics is indicated/justified lies in the balance of risk of pulmonary bacterial coinfection (or risk of not diagnosing it), severity of disease and the patient setting. The balance between the overprescription of antibiotics and the possible sequelae associated with bacterial coinfection in infants and children continues to fuel debate.

Keywords::

• bacterial coinfection
• children
• concomitant pneumonia
• infants
• influenza
• respiratory syncytialvirus

Financial & competing interests disclosure

A Riordan has undertaken postmarketing surveillance for GlaxoSmithKline with reference to intravenous zanamivir. Payment for this was made directly into a charitable trust. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Notes

CAP: Community-acquired pneumonia; im.: Intramuscular; iv.: Intravenous.

Data taken from [25].