An international standardization to study the clinical use of lung ultrasound to discriminate viral, bacterial and atypical pneumonia in children with community acquired pneumonia.

Background: Community-acquired pneumonia (CAP) is a leading cause of morbidity and mortality in the pediatric population worldwide. Establishing a definitive etiological diagnosis in children with CAP remains challenging, as clinical, laboratory, and radiologic findings are often insufficient. Consequently, empirical and frequently unnecessary antibiotic treatments are commonly prescribed.

Main body: Lung ultrasound (LUS) has demonstrated diagnostic accuracy comparable to chest X-ray (CXR) for CAP, while eliminating radiation exposure. Emerging evidence suggests that LUS may also differentiate the underlying etiologies of CAP. Assuming that distinct CAP etiologies exhibit characteristic LUS features, we aim to design a study protocol to develop a predictive model that integrates a child's clinical information with their specific LUS patterns to inform individualized treatment strategies.

Conclusions: This clinical approach will comprehensively evaluate clinical, laboratory, LUS, and outcome data from pediatric patients with CAP of various causes. If more centers will use the same approach, this will allow to gather in the short time data from large and diverse cohorts to facilitate the optimization and understanding of how LUS can potentially help understanding the etiology of CAP. The integrated data will be used to support tailored management strategies for pediatric CAP.