Background
Streptococcus pneumoniae is the most common bacterial
agent in pediatric community-acquired pneumonia
(CAP) at any age, while Mycoplasma pneumoniae is
more common among patients over 5 years of age [1].
The majority, over 90%, of basically healthy, western
children with CAP clinically improve with disappearance
of fever and reduction of breathing work within 48
hours after the onset of antibiotics, with no significant
differences between beta-lactames and macrolides as
first-line antibiotics [2-4]. In recent years, pneumococcal
macrolide resistance has become an emerging problem
[1], and complications such as empyema and even
necrotizing pneumonia have become more common
than earlier, particularly complicating pneumococcal
pneumonia [5-7]. Therefore, most international and
national guidelines recommend penicillin, amoxicillin or
other beta-lactames as first antibiotic choice for all children
with CAP at