Managing and preventing childhood pneumonia in South Africa: Updated South African guidelines

The two articles in this edition of CME follow up on those in the previous edition, i.e. epidemiology/aetiology and diagnosis of community-acquired pneumonia (CAP) in children. The articles in this issue cover recommendations on management and prevention of childhood pneumonia. Management of a child with cough or difficult breathing needs a context. Most coughs are due to upper respiratory tract infections (URTIs) – almost all are viral in aetiology and rarely require antibiotics. The World Health Organization (WHO) added to that strategy, recommending that children with acute cough, who are not ‘fast breathing’, have by definition a URTI and do not need antibiotics. Two major consequences as a result of inappropriate antibiotic use include emergence of antimicrobial resistance and dysbiosis of the human microbiome. Both of these contribute to morbidity and mortality.