Infectious diseases precipitate the majority of acute medical admissions to the pediatric intensive care unit (PICU) despite the availability of a wide variety of antimicrobial agents. In previously healthy children, specific therapy is likely to have only a minimal impact on the continuing severity of the disease, since it is usually the host response to the infection that determines progression, and strategies that avoid admission are clearly preferable. Prophylactic immunization offers the potential for prevention of PICU admission for many of the major pathogens affecting children. Indeed, vaccines already exist for many of the causes of the major infectious syndromes presenting to PICU (Table 5.1).
