Community-acquired pneumonia (CAP) remains one of the main causes of children’s morbidity and hospitalization. The diagnostic mistakes and delayed or inadequate therapy continue to persist. The aim of the paper is to discuss the up-date CAP recommendations for the diagnostics improvement and increasing the efficacy of antibiotic therapy in outpatients. There is evidence of frequent inaccurate pneumonia diagnostics based on clinical features. As experts of WHO consider, only combination of fever > 38.5 °C and respiratory disorders syndrome has the diagnostics value in case of bronchial obstruction absence. The author pays attention to the fact that a necessary condition for effective CAP therapy is information about the agents and level of their resistance to antibiotics. According to the data of the performed investigations the etiologic structure of children’s CAP didn’t principally change: in children under 5 years viruses and Streptococcus pneumonia play the main role; whereas in older children the frequency of atypical infections competes with the frequency of pneumococcal ones. The author presents the data about the level of Streptococcus pneumonia resistance to antibiotics and discusses the etiologic diagnostic methods available for outpatient practice. There are differences between American and European experts concerning the prescription of antibiotics and the choice of initial medication: amoxicillin (co-amoxiclav) or macrolides. However, the situation of widespread prescription of macrolides for schoolchildren causes great concern, as this may promote increase of Streptococcus pneumonia resistance to antibiotics. The author discusses the possibility to use 5–7-day courses of antibiotics for mild or moderate CAP.
