Systematic review of clinical practice guidelines on the management of community acquired pneumonia in children |
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| Affiliation: | 1. Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Australia;2. The Children''s Hospital at Westmead, Sydney Children’s Hospitals Network, Sydney, NSW 2145, Australia;1. Department of Paediatric Pulmonology, Immunology and Intensive Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany;2. Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centers, Amsterdam Infection & Immunity, Amsterdam Public Health, University of Amsterdam, Amsterdam, The Netherlands;3. Department of Radiology, The Children’s Hospital of Philadelphia, USA;4. Department of Radiology, The Perelman School of Medicine, University of Pennsylvania, USA;5. Berlin Institute of Health, Berlin, Germany;1. UCL Great Ormond Street Institute of Child Health, London, UK;2. Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK;1. Depts. Paediatric Cystic Fibrosis, Royal Brompton Hospital, London, UK;2. Depts. Paediatric Clinical Psychology, Royal Brompton Hospital, London, UK;3. Adult Cystic Fibrosis Centre, Royal Brompton Hospital, London, UK;4. National Heart and Lung Institute, Imperial College London, London, UK;1. Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa;2. Division of Paediatric Pulmonology and Allergology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria;3. Division of Medical Microbiology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University and National Health Laboratory Service, Tygerberg Hospital, Cape Town, South Africa;4. Division of Anatomical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University and National Health Laboratory Service, Tygerberg Hospital, Cape Town, South Africa |
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| Abstract: | Childhood community acquired pneumonia (CAP) is the leading cause of mortality in children under 5 years worldwide. Clinical practice guidelines (CPGs) may be limited by method of development, scope of recommendations and the quality of supporting evidence. This study systematically identified, appraised and compared the recommendations of CPGs for the management of paediatric CAP using the AGREE II tool.The systematic review yielded 1409 non-duplicate results, of which 14 CPGs were appraised. Four of the fourteen CPGs were deemed high quality. Most CPGs were considered low-medium quality with ‘rigour of development’ and ‘applicability’ the weakest domains. These areas should be considered in deriving CPGs in the future. Recommendations were generally similar across all guidelines; however, there was notable heterogeneity in three areas. This suggests the need for further evidence to guide management decisions on oxygen saturation thresholds for admission, the utility of investigations such as acute phase reactants, and the duration of antibiotic therapy. |
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| Keywords: | Children Guideline Community acquired pneumonia AGREE II |
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