Chest Radiograph Effective for Excluding Pediatric Pneumonia

CXR had negative predictive value of 98.8% in children evaluated for suspected pneumonia.
CXR had negative predictive value of 98.8% in children evaluated for suspected pneumonia.

HealthDay News — A negative chest radiograph (CXR) accurately excludes pneumonia in the majority of children, according to a study published in the September issue of Pediatrics.

Susan C. Lipsett, MD, from Harvard University in Boston, and colleagues evaluated the negative predictive value of CXR among 683 children (aged 3 months to 18 years) evaluated in a pediatric emergency department for suspected pneumonia over 2 years. CXR results were classified as positive, equivocal, or negative. Children who had negative CXRs and no clinical diagnosis of pneumonia were managed for 2 weeks after the emergency department visit, and those diagnosed with pneumonia during the follow-up period were considered to have had false-negative CXRs. 

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The researchers found that 72.8% of children had negative CXRs, with 8.9% of these children clinically diagnosed with pneumonia and 9.3% given antibiotics for other bacterial syndromes. Five of the 411 children with negative CXRs who were managed without antibiotics were subsequently diagnosed with pneumonia within 2 weeks (negative predictive value of CXR, 98.8%).

"Children with negative CXRs and low clinical suspicion for pneumonia can be safely observed without antibiotic therapy," the authors write.

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