Children > 3 months - 5 years
[Paediatr Child Health 2015;20:441-5, Clin Infect Dis 2011; Aug: e1-52, and Thorax 2011;66:ii1-23]
Diagnosis
- Chest x ray recommended to confirm diagnosis whenever possible and if deterioration to rule out empyema.
Usual Pathogens
Viral:
RSV
Adenovirus
Bocavirus
Human metapneumovirus
Influenza
Parainfluenza
Coronavirus
Rhinovirus
No antibiotic therapy recommended
Bacterial:
S. pneumoniae
H. influenzae
S. aureus/MRSA
Group A Streptococci
Mycoplasma pneumoniae
Chlamydia pneumoniae
Mild-moderate
| Empiric Therapy | Duration | |
|---|---|---|
| Amoxicillin | 40-90mg/kg/d PO div tid | 5 days |
Mild-moderate & ß-lactam allergy
| Empiric Therapy | Duration | |
|---|---|---|
| Azithromycin | 10mg/kg PO first day, then 5mg/kg PO daily x 4 days | 5 days |
| or | ||
| Clarithromycin | 15mg/kg/d PO div bid |
Mild-moderate & Post-influenza
| Empiric Therapy | Duration | |
|---|---|---|
| Cefuroxime | 150mg/kg/d IV div q8h | |
| or | ||
| Amoxicillin-clavulanate | 45mg/kg/d PO div tid |
Hospitalized
| Empiric Therapy | Duration | |
|---|---|---|
| Ampicillin | 200mg/kg/d IV div q6h |
PICU admission
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Ceftriaxone | 100mg/kg IV q24h | |
| +/- | ||
| Vancomycin | 60mg/kg/d IV div q6h | |
| +/- | ||
| Azithromycin | 10mg/kg IV/PO first day, then 5mg/kg IV/PO daily x 4 days | 5 days |