From the Guidelines
The most common cause of pneumonia post Covid-19 in children is bacterial superinfection, with Streptococcus pneumoniae and Haemophilus influenzae being the predominant pathogens [ 1 ].
Key Pathogens
- Streptococcus pneumoniae: the most common bacteria [ 1 ]
- Haemophilus influenzae: another common pathogen [ 1 ]
- Staphylococcus aureus: also a possible cause [ 1 ]
Treatment
Treatment typically involves administration of amoxicillin-clavulanate (80-100 mg/kg/day divided every 8 hours) or ceftriaxone (50-75 mg/kg/day once daily) for 7-10 days, depending on the severity of the infection and local antimicrobial resistance patterns [ 1 ].
Special Considerations
In cases of suspected methicillin-resistant Staphylococcus aureus (MRSA) infection, vancomycin (15-20 mg/kg/dose every 6-8 hours) may be added to the treatment regimen.
Diagnosis
Diagnosis of pneumonia is based on clinical symptoms, including fever, acute respiratory symptoms, and radiographic findings [ 1 ].
Hospital-Acquired Pneumonia
Hospital-acquired pneumonia is defined as pneumonia that develops after 48 hours of hospitalization that was not present at the time of admission [ 1 ].
From the Research
Causes of Pneumonia post COVID-19 in Pediatric Patients
- The most common cause of pneumonia post COVID-19 in pediatric patients is not explicitly stated in the provided studies, but some studies suggest that bacterial co-infections are a significant concern 2, 3.
- A study published in 2024 found that group A Streptococcus (GAS) is a dominant cause of complicated community-acquired pneumonia (CAP) in children, constituting 24.2% of the study group 4.
- Another study published in 2020 found that bacterial co-infections are relatively infrequent in hospitalized COVID-19 patients, but when they do occur, they can be caused by a variety of bacteria, including Klebsiella species, Staphylococcus aureus, and Streptococcus pneumoniae 3.
- The study published in 2023 found that Klebsiella pneumoniae, Acinetobacter baumannii, and Enterococcus spp. are the most frequently isolated bacteria in COVID-19 patients with bacterial superinfections 5.
Bacterial Co-infections in COVID-19 Patients
- Bacterial co-infections are a significant concern in COVID-19 patients, and can be caused by a variety of bacteria, including Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus 2.
- The use of antibiotics is crucial in the treatment of bacterial co-infections, but the overuse and misuse of antibiotics can contribute to the development of antibiotic-resistant bacteria 3, 5.
- The study published in 2024 found that GAS pneumonia in children is associated with a more severe course of disease, including longer hospitalization and higher incidence of chest tube insertion 4.
Clinical Management of COVID-19 Pneumonia in Pediatric Patients
- The clinical management of COVID-19 pneumonia in pediatric patients is crucial, and requires careful monitoring and treatment of bacterial co-infections 6.
- The study published in 2020 found that respiratory management dominates the clinical picture of hospitalized COVID-19 patients, even in children, and that deterioration of the clinical picture can occur rapidly 6.
- The use of procalcitonin levels can be helpful in identifying patients with bacterial co-infections, and in guiding antibiotic therapy 5.