Diagnosing Pediatric Pneumonia Without a Chest X-Ray

This study shows a promising decline in CXRs in children with community-acquired pneumonia, fever, and respiratory illnesses, but it may overestimate rates of guideline-concordant imaging across most U.S. hospitals.

Pediatric guidelines recommend against the routine use of chest x-rays (CXRs) to diagnose community-acquired pneumonia (CAP) because CXRs don't reliably differentiate bacterial and viral pneumonia (NEJM JW Pediatr Adolesc Med Nov 2011 and Clin Infect Dis 2011 Oct; 53:617). One potential downside of this approach is an increase in clinically diagnosed CAP and, consequently, antibiotic use.

To evaluate trends in use of CXRs and diagnosis of CAP, researchers analyzed records for children aged 3 months to 18 years who visited emergency departments (EDs) at 30 tertiary-care pediatric hospitals between 2008 and 2018 and received a diagnosis of CAP, fever, or respiratory illness. Over the study period, overall CXR usage in all ED patients declined …

Reviewing Author

Lauren M. Westafer, DO, MPH, MS

Disclosures

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsAnnals of Emergency Medicine

Leadership Positions in Professional SocietiesAcademy for Academic Women in Emergency Medicine (Social Media Chair)

Lauren M. Westafer, DO, MPH, MS

Disclosures

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsAnnals of Emergency Medicine

Leadership Positions in Professional SocietiesAcademy for Academic Women in Emergency Medicine (Social Media Chair)

Diagnosing Pediatric Pneumonia Without a Chest X-Ray

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Reviewing Author