Treatment of infections due to resistant organisms

Antibiotic resistance remains rare in paediatric community-acquired pneumonia in the UK, but is more common in hospital-acquired pneumonia and in patients with chronic lung diseases. It should also be considered in children arriving from countries with a high prevalence of antibiotic resistance, children with previous heavy antibiotic exposure, those who are immunosuppressed, and those who are not responding to conventional therapy. The most frequent bacterial cause of paediatric pneumonia is Streptococcus pneumoniae and globally there are major concerns about the increasing resistance of this organism to penicillin. intermediate resistance may be overcome with conventional doses of parenteral penicillin and there is as yet no convincing evidence that intermediate/high level resistance is associated with a worse clinical outcome. Continued vigilance and research is required. The recently introduced pneumococcal conjugate vaccines offer great promise as they are likely to prevent cases of disease due to penicillin-resistant serotypes.