Pneumococcal Disease Treatment

Preventing pneumococcal disease in the first place is critical to improving child survival and health. However, appropriate treatment can also save lives and minimize suffering.

Antibiotics are the mainstay of pneumococcal disease treatment

The treatment for pneumococcal disease is prompt, appropriate antibiotic therapy. These antibiotics often cost less than one dollar per day. The type of antibiotic, route of administration (e.g. oral or intravenous), and duration of treatment depends on several factors:

• Clinical syndrome (pneumonia, meningitis, sepsis, otitis media)
• Severity of diseases
• Age of child
• Local patterns of antimicrobial resistance

In addition, treatment providers may have to consider other aspects of the local setting, such as the presence of high-risk groups, including undernourished or HIV-positive children.

Many children do not receive appropriate treatment for pneumococcal disease

Antibiotics can be life-saving in cases of infections caused by pneumococcal bacteria. It can sometimes be difficult, however, for healthcare providers to distinguish between infections caused by bacteria compared to other organisms, such as viruses or parasites. For example, in some countries, particularly in Africa, children with pneumonia are sometimes midiagnosed as having malaria. In these cases, children may never receive potentially life-saving antibiotics, or their treatment may be delayed until the disease becomes more severe. There are several additional reasons why children with pneumococcal disease, particularly pneumococcal pneumonia, may not receive appropriate treatment:

• Parents and caregivers may not recognize pneumococcal disease symptoms in a child and/or know to take the child to a health provider
• They may face barriers to accessing appropriate care for a child with suspected pneumococcal disease, such as cost of treatment and distance to a health center
• Families may mistrust the health system, and may prefer to seek advice from other unqualified individuals
• Healthcare providers may misdiagnose a child with pneumococcal disease and therefore fail to administer appropriate treatment

Antibiotic resistance is an increasing concern

Giving antibiotics unnecessarily to treat a viral infection can contribute to the emergence of antibiotic resistance. Pneumococcal bacteria are increasingly becoming resistant to common antibiotics, such as penicillin, thus making it harder and more costly to treat these pneumococcal infections.

Treatment can be costly for families and communities

In addition to the heavy emotional toll of illness, pneumococcal disease can cause serious financial difficulties for families and communities, contributing to the cycle of poverty. The costs of illness include:

• Direct medical costs of illness (e.g. hospital costs, medical personnel time, diagnostics and medications)
• Non-medical direct costs (e.g. transportation to healthcare facilities, food while hospitalized)
• Productivity costs (e.g. lost work time for family members who must care for ill children)

Further, treatment may be inadequate to prevent devastating sequelae of the disease (e.g. deafness from pneumococcal meningitis). And time is of the essence. Delays in treatment may increase the chance of disability and death.