The prognosis for childhood CAP in the developed world is generally good. With appropriate treatment, most children make a full recovery with no long-term sequelae.[9]Harris M, Clark J, Coote N, et al; British Thoracic Society Standards of Care Committee. British Thoracic Society guidelines for the management of community acquired pneumonia in children: update 2011. Thorax. 2011 Oct;66 Suppl 2:ii1-23.
https://www.brit-thoracic.org.uk/quality-improvement/clinical-resources/paediatric-community-acquired-pneumonia
http://www.ncbi.nlm.nih.gov/pubmed/21903691?tool=bestpractice.com
The overall rate of complicated CAP was 3% among 7274 children included in a British Thoracic Society audit.[74]Legg J, Rampton C. British Thoracic Society paediatric pneumonia audit. National audit period: 1 November 2016 - 31 January 2017. Jan 2018 [internet publication].
https://www.brit-thoracic.org.uk/quality-improvement/clinical-audit/bts-national-audit-reports-full-list
However, among children hospitalised for CAP, a US study of 2638 children reported that 13% developed complicated CAP.[4]Jain S, Williams DJ, Arnold SR, et al; CDC EPIC Study Team. Community-acquired pneumonia requiring hospitalization among U.S. children. N Engl J Med. 2015 Feb 26;372(9):835-45.
https://www.nejm.org/doi/10.1056/NEJMoa1405870
http://www.ncbi.nlm.nih.gov/pubmed/25714161?tool=bestpractice.com
Morbidity is higher for complicated CAP and long-term sequelae can rarely develop, but the mortality rate is low at <0.5% and usually limited to children with previous underlying disease.[2]de Benedictis FM, Kerem E, Chang AB, et al. Complicated pneumonia in children. Lancet. 2020 Sep 12;396(10253):786-98.
http://www.ncbi.nlm.nih.gov/pubmed/32919518?tool=bestpractice.com
Complicated CAP can have a prolonged clinical course, particularly for necrotising pneumonia, but complete recovery remains the usual outcome, with no clinical, radiological, or lung function consequences by 6-9 months after discharge for almost all children.[2]de Benedictis FM, Kerem E, Chang AB, et al. Complicated pneumonia in children. Lancet. 2020 Sep 12;396(10253):786-98.
http://www.ncbi.nlm.nih.gov/pubmed/32919518?tool=bestpractice.com
[9]Harris M, Clark J, Coote N, et al; British Thoracic Society Standards of Care Committee. British Thoracic Society guidelines for the management of community acquired pneumonia in children: update 2011. Thorax. 2011 Oct;66 Suppl 2:ii1-23.
https://www.brit-thoracic.org.uk/quality-improvement/clinical-resources/paediatric-community-acquired-pneumonia
http://www.ncbi.nlm.nih.gov/pubmed/21903691?tool=bestpractice.com
The prognosis is less good in low- and middle-income countries. In 2019, pneumonia accounted for 14% of deaths globally in children under 5 years old and 22% among those aged 1-5 years.[6]World Health Organization. Factsheet: pneumonia in children. Nov 2022 [internet publication].
https://www.who.int/news-room/fact-sheets/detail/pneumonia
However, mortality rates have declined in countries where conjugate pneumococcal vaccination has been widely introduced.