Bibliographic information
GuidelineWHO consolidated guidelines for the management of common childhood illness: management of sickle-cell disease in children and adolescents
Year of Publication2026
Issuing InstitutionWorld Health Organization
Recommendation
New
In children and adolescents (aged 0–19 years) with sickle-cell disease (SCD) and a clinical diagnosis of acute chest syndrome (ACS), the use of antibiotics in addition to standard therapeutic and supportive interventions is suggested.
Recommended in favor
Conditional
Certainty of evidence
Low
Notes and Remarks
- Empirical broad-spectrum antibiotic therapy should include a third-generation cephalosporin to cover common Gram-negative and Gram-positive organisms, along with a macrolide to target atypical bacteria such as Mycoplasma pneumoniae and Chlamydia pneumoniae.
- Where available, local bacterial prevalence and antimicrobial susceptibility patterns should guide the choice of specific antibiotics.
- In children, distinguishing ACS from pneumonia can be challenging due to overlapping clinical features. Infectious causes are more likely to be implicated in children than in adults.
- In cases of cephalosporin allergy, appropriate antibiotic alternatives should be considered based on local guidelines and susceptibility data.
- Standard therapeutic and supportive interventions for ACS include pain management, IV fluids, oxygen supplementation, blood transfusion or exchange transfusion, and respiratory support, as clinically indicated.