**1. Introduction**

Pneumonia commonly described as infection of lungs is classified according to where or how it is acquired: community-acquired, healthcare-associated, hospital-acquired, or ventilatorassociated pneumonia [1, 2]. According to the area of lung affected, pneumonia can be lobar pneumonia, bronchial pneumonia, and acute interstitial pneumonia [2]. Pneumonia can be

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. © 2017 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

bacterial, viral, and less commonly fungal [3]. In the pediatric age group, pneumonia may additionally be classified as non-severe, severe, or very severe depending on the signs and symptoms [4].

that more death of children occurs due to pneumonia than any other diseases. According to a study conducted in India [11], the average cost per patient not put on ventilator is INR 27,123, whereas the cost associated with ventilated patient is almost twice INR 44,812. Ventilator support is the most expensive intervention adding to the cost of care followed by the cost of antibiotics and investigations and still making the patient more prone to complicated infections like biofilm. Thus, the disease adds significantly to the cost of hospital care and to the length of hospital stay. The situation does not seem to improve as antibiotic pipeline is virtually dry and the resistance appears to be further mounting in most parts of the world as per the latest

Advancing in the Direction of Right Solutions: Treating Multidrug-Resistant Pneumonia

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The etiology of pneumonia in high-income countries is different than in low-income countries [12, 13]. It has been reported that viruses contribute to 30–67% cases of CAP in developed countries and are more frequently identified in children aged less than 1 year than in those aged above 2 years [12]. Bacteria are more frequently identified with increasing age, resulting

Respiratory syncytial virus (RSV) is the prime cause of viral pneumonia in children admitted to hospital in developing countries, followed by influenza A and B, parainfluenza, human metapneumovirus, and adenovirus [13]. The bacterial pathogens causing pneumonia include *Pseudomonas aeruginosa, Haemophilus influenza* type b, *Acinetobacter baumannii, Klebsiella pneumoniae, Escherichia coli, Staphylococcus aureus*, methicillin-resistant *S. aureus*

The outline for the diagnosis of pneumonia is highlighted in WHO/UNICEF Integrated Management of Childhood Illness (IMCI) guidelines. Fever and cough are the most common ones. Fever is present in 65–90% and cough in 75–96% of patients with pneumonia. Other typical respiratory complaints include sputum production, dyspnea, and chest pain [16]. In a hospital, there are numerous investigations available including radiography and microbio-

The treatment of pneumonia depends on the age, the severity of illness, the likely causative agents, and their resistance patterns. Guidelines recommended the use of third- and fourthgeneration cephalosporins, BL + BLI (β-lactam + β-lactamase inhibitor) combinations, and even carbapenems for the management of Gram-negative infections and vancomycin/line-

Center for Disease Dynamics, Economics and Policy (CDDEP) reports.

in mixed infections being less common with age [12].

(MRSA), and *Streptococcus pneumoniae* [8, 14, 15].

logical methods to investigate pneumonia.

zolid for the management of Gram-positive infections.

**5. Etiology**

**6. Diagnosis**

**7. Treatments**
