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Guidelines
Pathogens
Antimicrobials
Most likely pathogens
7-10 days (including oral conversion when afebrile for 24-48 hours)
If previously healthy and up tp date on Hib immunizations:
Ampicillin 50 mg/kg/dose IV q6h Maximum: 2 grams/dose
OR
If NOT up to date on Hib immunizations:
Ceftriaxone 50-75 mg/kg/dose IV q24h Maximum: 2 grams/dose
+ / -
If greater than 5 years of age and suspected atypical pneumonia, add:
Clarithromycin 7.5 mg/kg/dose PO BID Maximum: 1 gram/24h
Note: Mycoplasma infections in children may resolve spontaneously, therefore not all suspected or confirmed infections require antimicrobial treatment
For all patients with suspected or proven Influenza, add oseltamivir.
Oral Conversion: If initially started on Ampicillin or initially started on Ceftriaxone and no pathogen identified and immunizations to Hib up to date: Amoxicillin Usual dose: 15-20 mg/kg/dose PO TID High dose: 25-30 mg/kg/dose PO TID Maximum: 4 g/24h (Usual maximum adult dose for CAP is 1g PO q8h)
Oral Conversion: If immunizations to Hib not up to date and no pathogen identified: Cefprozil 15 mg/kg/dose PO BID Maximum: 1 gram/24h
