Acute Pneumonia in Children – Illness or Infection?" - Open Letter to the Editorial Staff

Abstract

Non-specific forms of Acute Pneumonia (AP) have been known in medicine for a long time, well beyond two millennium. "Pneumonia was described 2,500 years ago by Hippocrates, the father of medicine" [1]. However, could someone state today that this nosology is also well-studied as it is well-known? The comparison of scientific explanation of AP nature and actual results of its treatment shows a lot of contradictions and paradoxes. The substantiated dissatisfaction by the contemporary state of this problem forces one to search the ways of its solution while investing enormously into this work. In this connection, it is recalled that World Health Organization has spent 39 billions of dollars in 2010-2015 years to solve this problem [2]. And where are the results? During last decades all difficulties and dangers in AP treatment were explained solely by biological aggression of its agents. This valuation, as a rule, is given in current moment, although AP etiology alters from time to time. For example, "Staphilococcal disaster" that happened in 60-70 years of last century "leaved the scene" quietly and today even the most dangerous Staphylococcal variety are rarity in AP etiology. In the years following that, other microorganisms replaced Staphylococcus including forms not previously found among exciters of AP. The current generation of doctors trained "in fear" in front of Streptococcus pneumonia. In this situation, the antibacterial medical assistance was supplemented by total vaccination of the population in developed countries. The results of this campaign also fell short of expectations. "Among children ≤18 years of age, the annual empyema-associated hospitalization rates increased almost 70% between 1997 and 2006, despite decreases in the bacterial pneumonia and invasive pneumococcal disease rates. Pneumococcal conjugate vaccine is not decreasing the incidence of empyema" [3]. Currently, the image of "new" infectious threats arises. "Respiratory viruses, rather than bacterial pathogens, were most commonly detected

Commentary to article: Esteban-Zubero E, García-Muro C, Alatorre-Jiménez MA, Marín-Medina A, López-García CA, Youssef A, Villeda-González R. Management of Community acquired pneumonia in the Emergency Room. Iberoam J Med. 2019;1(1):3-15

“…In other words, inflammation progresses despite suppression of microflora [1]. If we now try to assess the practical benefits of the dominant desire by any means to determine the causative agent of CАP, then, from my point of view, it is purely declarative and does not have a decisive (as implied and asserted in modern publications) influence on the final results of treatment [2][3][4][5]. Finally, another section of the review deserves attention, which also follows from the infectious concept of the disease and is more indicative and recommendatory than a guide to the practical effects on the course of the inflammatory process in the lungs.…”

The New Doctrine of Acute Pneumonia-the Key to Solve the Problem

“…Triumphal start of the era of antibiotics gave rise to an atmosphere of euphoria. However, hopes for the effectiveness of one of the universal remedy remain the main focus of the strategy and tactics in AP for the past several decades [5,6]. Antibiotics are considered such a panacea [7].…”

Is it Possible to Create a Universal Cure for Pneumonia?

“…It is well known that pneumonia is not a contagious of infectious diseases and not in need of appropriate measures for the health and safety [12]. It is also common knowledge that many people are carriers of the entire spectrum of microbes that are pathogens of АP.…”