Prognosis

​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]​ The overall rate of complicated CAP was 3% among 7274 children included in a British Thoracic Society audit.[74]​ However, among children hospitalised for CAP, a US study of 2638 children reported that 13% developed complicated CAP.[4]​ 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]​ 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][9]

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]​ However, mortality rates have declined in countries where conjugate pneumococcal vaccination has been widely introduced.

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