Chest Radiography for Presumed Pneumonia in Children

This interactive case discussion evaluates whether empirical antibiotics or chest radiography should guide treatment for a febrile 4-year-old with presumed pneumonia. Expert essays debate clinical judgment versus diagnostic imaging in outpatient pediatric settings. One perspective favors antibiotics based on clinical signs and epidemiologic data, citing radiography's limited influence on management decisions. The opposing view highlights the harms of unnecessary antibiotics and promotes radiography’s high negative predictive value. The piece underscores challenges in distinguishing bacterial from viral pneumonia and the importance of shared decision-making with caregivers.

This interactive case discussion evaluates whether empirical antibiotics or chest radiography should guide treatment for a febrile 4-year-old with presumed pneumonia. Expert essays debate clinical judgment versus diagnostic imaging in outpatient pediatric settings. One perspective favors antibiotics based on clinical signs and epidemiologic data, citing radiography's limited influence on management decisions. The opposing view highlights the harms of unnecessary antibiotics and promotes radiography’s high negative predictive value. The piece underscores challenges in distinguishing bacterial from viral pneumonia and the importance of shared decision-making with caregivers.