Paediatric Pneumonia Antibiotic Treatment

Paediatric Pneumonia Antibiotic Treatment
This is from the Antibiotic Guidelines (2010) edition of the Therapeutic Guidelines. It’s a bit detailed to memorise for the exam, but gives you an idea of the drugs used and the doses.

Birth-1Week
Benzylpenicillin 60mg/kg bd IV for 7 days
PLUS
Genatmicin 3-3.5mg/kg IV daily for 7 days

1week-4 months
Mild:
Azithromycin or Erythromycin (orally)

Febrile/Unwell:
Benzylpenicillin 30mg/kg IV qid

Severe (toxic, rapidly progressive)
Cefotaxime 25mg/kg IV 8hrly

4mths-5yrs
Mild
Amoxycillin 25mg/kg (oral) tds

If that fails after 3 days convert to:
Benzylpenicillin 30mg/kg IV qid

Severe:
Cefotaxime 25mg/kg IV 8hrly
OR
Ceftriaxone 25mg/kg IV 8hrly PLUS di/flucloxacillin 50mg/kg IV qid

5-15 years
Common bugs: Strep pneumoniae, Mycoplasma pneumoniae

Mild:
Amoxycillin 25mg/kg oral tds
OR (If mycoplasma suspected)
Clarithromycin 7.5mg/kg oral (up to 250mg) bd
OR
Roxithromycin 4mg/kg oral (up to 150mg) bd

Severe
Benzylpenicillin 30mg/kg IV qid
PLUS
Clarithromycin 7.5mg/kg oral (up to 250mg) bd
OR
Roxithromycin 4mg/kg oral (up to 150mg) bd

Tropical Australia
Consider melioidosis, (uncommon in children, unless diabetic, CF, rheumatic/congenital heart disease).

Severe:
4mths-5yrs
Meropenem 25mg/kg IV tds
5-15 yrs
Meropenem 25mg/kg (up to 1g) IV tds
PLUS
Clarithromycin 7.5mg/kg oral (up to 250mg) bd
OR
Roxithromycin 4mg/kg oral (up to 150mg) bd

A last point is on Staphylococcal pneumonia: Suspect if severely unwell/toxic, and sigs of abscess on CxR.
The main point is Get Expert Advice, and treat with:
Flucloxacillin
OR
Cefazolin (if allergic)
OR
Vancomycin (if severes/MRSA)
OR
Linezolid