Objective: To determine the etiology of recurrent pneumonia in infants and to identify the factors associated with age at first episode and episode frequency.

Material and Methods: Children that had their first episode of pneumonia at age 1-24 months and met the diagnostic criteria for RP were included in the study. Their records were screened for conditions that may have been associated with pneumonia, including aspiration syndromes, congenital disorders, airway obstruction and secretion clearance disorders, immune deficiencies, and pulmonary hemosiderosis. The correlation between risk factors, and age at first episode and the frequency of episodes were evaluated separately for patients with and without an underlying etiology.results: In all, 60 patients (33.9%) had congenital birth defects, 55 (31%) had aspiration syndrome, 19 (10.8%) had airway obstruction, 7 (4%) had immune deficiency, 4 (2.3%) had cystic fibrosis, 2 (1.1%) had pulmonary tuberculosis, and 1 (0.6%) had pulmonary hemosiderosis. Of the patients; 29 (16.3%) had no specific etiology. In the patients without a discernible underlying disorder, risk factors (a history of exposure to cigarette smoke, ≥5 household members, insufficient breastfeeding) were significantly associated with a higher frequency of pneumonia episodes. Multiple logistic regression analysis showed that exposure to cigarette smoke was a risk factor for recurrent pneumonia episodes, independent of the other risk factors evaluated conclusion: Exposure to cigarette smoke, an overcrowded household, and insufficient breastfeeding were determined to be highly probable risk factors associated with the higher frequency of episodes in the RP patients without an underlying disorder

Keywords: Pneumonia, Recurrent pneumonia, Children