Antimicrobial resistance (AMR) remains one of the top 10 global public health threats facing humanity, threatening many of the health gains that have been achieved in the past century. Optimising the use and choice of antimicrobials requires a clear understanding of microbial pathogens, non-pathogenic microbial passengers and the relative contribution of the host response to disease. This distinction remains a challenge in populations, clinical settings and anatomical sites where optimal specimen collection is difficult – there is no better example of this than the respiratory tract of children presenting with mild to moderate lower respiratory tract infection.
In children, viruses are the most frequently detected microbial pathogens/passengers in the respiratory tract. Optimising approaches to identify those with primary or secondary viral or bacterial respiratory infection, and mixed co-infection remains a global challenge. New approaches and solutions must be found if we are to have an impact on both AMR and global child health. Data on the current knowledge and new approaches to the diagnosis and management of acute lower respiratory tract infection will be presented.