Health care has become political and that means everyone wants everything for little money, at least when it comes to their own treatment or those in their family. The other edge of the political sword is lawyers waiting to sue, which has led to high malpractice costs and even higher costs due to "defensive medicine" - running unnecessary tests and engaging in procedures doctors know aren't valuable in order to check off boxes if a lawsuit happens.

Though antibiotics are useless for most cases of community-acquired pneumonia and chest x-rays are only recommended in specific instances, a new analysis found that preschool children were prescribed antibiotics in nearly 74 percent of outpatient visits while chest x-rays were obtained in 43 percent of visits.

Community-acquired pneumonia is one of the most common infections in children, accounting for about 1.5 million healthcare visits each year in the United States. In 2011, clinical guidelines for pediatric community-acquired pneumonia were issued by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. These groups recommend against routine chest x-ray, complete blood count and blood cultures, as well as against routine antibiotics for preschool children treated as outpatients. 

To evaluate the effect of this guideline, the authors examined national data representing an estimated 6.3 million visits to outpatient clinics and emergency departments during 2008-2015 by children 1 to 6 years of age with community-acquired pneumonia. They found that high use of non-recommended diagnostic tests and antibiotics persisted over the entire study period, and that the 2011 guidelines had no impact on practice.