Asthma-community acquired pneumonia co-diagnosis in children: a scoping review

Abstract

Objective

This scoping review investigated the existing literature and identified the evidence gaps related to diagnosis and management in children aged 2–18 years presenting to hospitals with a co-diagnosis of asthma and community-acquired pneumonia.

Data sources

We designed a scoping review following Arksey and O’Malley’s scoping review framework and PRISMA extension for a scoping review. We searched literature using five electronic databases: PubMed, CINAHL, Scopus, Web of Science, and Embase from 2003 to June 2023.

Results

A total of 1599 abstracts with titles were screened and 12 abstracts were selected for full review. Separate guidelines including Modified Global Initiative for Asthma (GINA) guidelines; modified Integrated Management of Childhood Illness (IMCI) guidelines; and a consensus guideline developed by the Pediatric Infectious Diseases Society (PIDS) and Infectious Diseases Society of America (IDSA) were used for diagnosing asthma and CAP individually. Chest X-rays were used in 83.3% (10/12) of studies to establish the co-diagnosis of asthma-CAP in children. Variations were observed in using different laboratory investigations across the studies. Infectious etiologies were detected in five (41.7%) studies. In 75% (9/12) of studies, children with asthma-CAP co-diagnosis were treated with antimicrobials, however, bacterial etiology was not reported in 44.4% (4/9) of the studies.

Conclusions

Our scoping review suggests that chest X-rays are commonly used to establish the co-diagnosis of asthma-CAP and antibiotics are often used without laboratory confirmation of a bacterial etiology. Clinical practice guidelines for the management of asthma and pneumonia in children who present with co-diagnosis may standardize clinical care and reduce variation.

Keywords:

• Asthma
• pneumonia
• CAP
• asthma-CAP co-diagnosis

Acknowledgements

We acknowledge the contribution of Dr. AYM Alamgir Kabir for providing assistance with the preparation of Figure 1.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Additional information

Funding

The authors(s) reported no funding associated with the scoping review.