PT - JOURNAL ARTICLE AU - Martin Wetzke AU - Katharina Schütz AU - Matthias Volkmar Kopp AU - Jürgen Seidenberg AU - Christian Vogelberg AU - Tobias Ankermann AU - Christine Happle AU - Gesche Voigt AU - Holger Köster AU - Thomas Illig AU - Christiane Lex AU - Antje Schuster AU - Ralph Maier AU - Marcus Panning AU - Grit Barten AU - Gernot Rohde AU - Tobias Welte AU - Gesine Hansen TI - Pathogen spectra in hospitalised and nonhospitalised children with community-acquired pneumonia AID - 10.1183/23120541.00286-2022 DP - 2023 Mar 01 TA - ERJ Open Research PG - 00286-2022 VI - 9 IP - 2 4099 - http://openres.ersjournals.com/content/9/2/00286-2022.short 4100 - http://openres.ersjournals.com/content/9/2/00286-2022.full SO - erjor2023 Mar 01; 9 AB - Background Paediatric community-acquired pneumonia (CAP) is a leading cause of paediatric morbidity. However, particularly for outpatients with paediatric CAP, data on aetiology and management are scarce.Methods The prospective pedCAPNETZ study multicentrically enrols children and adolescents with outpatient-treated or hospitalised paediatric CAP in Germany. Blood and respiratory specimens were collected systematically, and comprehensive analyses of pathogen spectra were conducted. Follow-up evaluations were performed until day 90 after enrolment.Results Between December 2014 and August 2020, we enrolled 486 children with paediatric CAP at eight study sites, 437 (89.9%) of whom had radiographic evidence of paediatric CAP. Median (interquartile range) age was 4.5 (1.6–6.6) years, and 345 (78.9%) children were hospitalised. The most prevalent symptoms at enrolment were cough (91.8%), fever (89.2%) and tachypnoea (62.0%). Outpatients were significantly older, displayed significantly lower C-reactive protein levels and were significantly more likely to be symptom-free at follow-up days 14 and 90. Pathogens were detected in 90.3% of all patients (one or more viral pathogens in 68.1%; one or more bacterial strains in 18.7%; combined bacterial/viral pathogens in 4.1%). Parainfluenza virus and Mycoplasma pneumoniae were significantly more frequent in outpatients. The proportion of patients with antibiotic therapy was comparably high in both groups (92.4% of outpatients versus 86.2% of hospitalised patients).Conclusion We present first data on paediatric CAP with comprehensive analyses in outpatients and hospitalised cases and demonstrate high detection rates of viral pathogens in both groups. Particularly in young paediatric CAP patients with outpatient care, antibiotic therapy needs to be critically debated.This prospective multicentre study analysed outpatients and hospitalised children with CAP. Clinical phenotype, pathogen spectra and outcome were compared. A high rate of viral pathogens in young children questions the use of antibiotics in this group. https://bit.ly/3fyxw0O