International Journal of Clinical Case Reports 2024, Vol.14, No.3, 157-166 http://medscipublisher.com/index.php/ijccr 159 3.2 Antibiotic regimens Antibiotics are often prescribed for ALRIs to prevent bacterial complications, although their effectiveness in children with uncomplicated lower respiratory tract infections (LRTIs) is debated. A systematic review and meta-analysis found insufficient evidence to support the use of antibiotics for preventing bacterial complications in children with undifferentiated acute respiratory infections (ARIs) (Galvão， 2016). Another randomized, placebo-controlled trial (ARTIC PC) evaluated the effectiveness of amoxicillin in children with uncomplicated LRTI and found no significant difference in the duration of symptoms between the antibiotic and placebo groups, suggesting that antibiotics may not be clinically effective for most children with chest infections unless pneumonia is suspected (Little et al., 2021). These findings highlight the need for judicious use of antibiotics to prevent resistance and unnecessary side effects. 3.3 Supportive care Supportive care remains a cornerstone in the management of ALRIs in children. Non-invasive ventilation (NIV) strategies, such as continuous positive airway pressure (CPAP) and high-flow nasal cannula (HFNC), have been shown to improve outcomes in pediatric patients with ALRIs. A systematic review and Bayesian network meta-analysis found that CPAP reduced the risk of intubation and treatment failure compared to standard oxygen therapy, while both CPAP and HFNC were associated with a lower risk of treatment failure (Figure 1). Additionally, supportive care measures such as supplemental oxygen, hydration, and nutritional support are essential in managing the symptoms and preventing complications in children with ALRIs. Figure 1 Network meta-analyses results (A) and cumulative probability under different rankings (B) for treatment failure and intubation (Adapted from Wang et al., 2021) Image caption: CPAP, continuous positive airway pressure; HFNC, high-flow nasal cannula; SOT, standard oxygen therapy (Adapted from Wang et al., 2021) In Figure 1, panels A and B comprehensively analyze the effectiveness of non-invasive ventilation (NIV) strategies in treating acute lower respiratory infections (ALRIs) in children. Panel A shows that CPAP and HFNC are more effective than standard oxygen therapy in reducing treatment failure, with CPAP being particularly notable. Panel B demonstrates the advantage of CPAP in reducing intubation rates, again significantly outperforming standard oxygen therapy. Overall, CPAP and HFNC, as NIV strategies, not only excel in reducing the risk of treatment failure but also significantly decrease the need for intubation, highlighting their critical role in the treatment of pediatric ALRIs. 3.4 Emerging treatments and novel therapies Emerging treatments and novel therapies are being explored to improve outcomes in children with ALRIs. The use of C-reactive protein (CRP) testing to guide antibiotic use in febrile children at risk of pneumonia has shown
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