Paediatrics: Pneumonia treatment
Oral antibiotics are safe and effective in the treatment of community-acquired pneumonia.
Oral antibiotics are safe and effective in the treatment of community-acquired pneumonia. IV antibiotics are used in children who cannot absorb oral antibiotics or in those with severe symptoms. The specific choice of antibiotic is based on the following:
- Age of the child.
- Host factors.
- The severity of illness.
- Information about cultures if known.
- CXR findings if known.
Antibiotic therapy for pneumonia
Streptococcus pneumonia is the most likely pathogen. The causes of atypical pneumonia are Mycoplasma pneumonia and Chlamydia trachomatis
- First-line treatment: amoxicillin
- Alternatives: co-amoxiclav or cefaclor for typical pneumonia; erythromycin, clarithromycin, or azithromycin for atypical pneumonia Over 5yrs
Mycoplasma pneumonia is more common in this age group
- First-line treatment: amoxicillin is effective against the majority of pathogens, but consider macrolide antibiotics if mycoplasma or chlamydia is suspected
- Alternatives: staphylococcus aureus is suspected to consider using a macrolide, or a combination of flucloxacillin with amoxicillin
Co-amoxiclav, cefotaxime, or cefuroxime IV
Consider whether any of the following are needed:
- Antipyretics for fever.
- IV fluids: consider if dehydrated or not drinking.
- Supplemental oxygen: administer oxygen via headbox or nasal cannula so that SpO2 is maintained >92%.
- Chest drain: for fluid or pus collections in the chest, as in empyema.
Chest physiotherapy is generally not beneficial in children with pneumonia and should not be performed.