Community acquired pneumonia (CAP) remains a major cause of childhood morbidity and mortality worldwide. There is still discrepancy in the definition, clinical diagnosis, identification of the causative pathogen, and treatment of CAP.

Having a high index of suspicion, using basic clinical skills in history and examination, and good knowledge of local prevalence of the microorganism and its resistance can guide the clinician to reach the most probable etiologic diagnosis of CAP to then treat it accordingly; avoiding under treatment (with risk of complications) and overtreatment (with risk of emergence of antibiotic resistance).

In this article, different aspects of paediatric CAP in developing and developed countries are reviewed; with some focus on comparing guidelines for CAP’s management. The difference between guidelines is shown, with a need to have local (national) guidelines considering the prevalence of the etiologic organisms and its antibiotic susceptibility to avoid the emergence of resistance.