Pneumonia is one of the most common serious bacterial infections in children worldwide, an important case of childhood morbidity and mortality globally, and a frequent and costly cause of emergency department (ED) visits and hospitalizations. Physicians currently rely on subjective impressions of clinical appearance to make initial site-of-care decisions. Such subjective judgments tend to overestimate disease severity in children with pneumonia; such overestimates are associated with the decision to hospitalize patients at low risk.

There is currently no evidence-based, validated tool to assist physicians in making targeted site-of-care and management decisions for children with community-acquired pneumonia (CAP). An evidence-based clinical prediction rule for CAP severity in children would assist physicians to accurately risk stratify children with CAP in the ED and improve clinical decisions. The objective of this study is to develop a clinical prediction rule to accurately identify children with CAP who are at risk for low, moderate and severe disease.

This study will include children diagnosed with CAP at Emergency Departments across the globe. Most sites will be part of the Pediatric Emergency Research Networks (PERN). Together, the research networks participating in PERN have access to data from over 3 million pediatric ED presentations annually, and to more than 100 hospitals, in five of the six WHO regions. This study will enhance clinical care and future research by moving from use of subjective impressions that do not adequately predict outcomes in children with CAP toward an evidence-based approach.

Study design                              

Multi-centre prospective cohort study (global)

Chief Investigators

Franz Babl (Australia)
Stuart Dalziel (NZ)
Todd Florin (USA)


2018 – 2022



Site locations

  • Gold Coast University Hospital, Southport, QLD, Australia
  • Townsville Hospital, Townsville, QLD Australia
  • Royal Children’s Hospital, Melbourne (PICU only)
  • John Hunter Hospital, Newcastle, NSW Australia
  • Logan Hospital, Brisbane, QLD Australia
  • Monash Medical Centre, Clayton, VIC Australia
  • Royal Hobart Hospital, Tasmania, Australia
  • Sydney Children’s Hospital, NSW, Australia
  • The Children’s Hospital at Westmead, Sydney, NSW Australia
  • Starship Children’s Hospital, Auckland New Zealand
  • Kidz First, Middlemore Hospital, Auckland, New Zealand
    ** Australia and NZ only


Approximately 5000 children with CAP (total from all sites), 3 months to <14 years


Catherine.wilson@mcri.edu.au, or

Clinical trials registration

To be confirmed.