PAEDIATRICS

ResponseStrep pneumoniae
Viral (Adeno/influenza/parainfluenza/RSV/HMPV)
Mycoplasma pneumoniae
Chlamydia pneumoniea

ResponseRecurrent bacterial pneumonia
Bronchiectasis
Inhaled foreign body
CF
Immune deficiency

ResponseFBC
Immunoglobupins
Sweat test
Bronchoscopy
CT chest

ResponseDisease factors, patient factors, social factors
Systemically unwell - shock
Oxygen requirement
Failed outpatient treatment
Poor oral intake/Failed TOF/Dehydartion
Significant comorbidities (eg: congenital heart disease)
A good social reason (Eg: mums a heroin addict selling herself on the street)

ResponseNonsevere
Amoxicillin 30 mg/kg TDS for 3-5 days (even if inpatient)
IV therapy required - Benpen 60 mg/kg QID
Penicillin Hypersensitivity - Azithromycin 10 mg/kg PO daily (Doxy but doses hard)
Penicillin hypersensitivity and need IV - Ciprofloxacin 10 mg/kg IV PLUS Vancomycin

Severe
Ceftriaxone 50mg/kg (max 1g) daily + Flucloxacillin 50 mg/kg (max 2g)
+ vancomycin if MRSA
+ azithro 10 mg/kg if pneumonia not improving

No proven benefit from treatment of mycoplasma pneumoniae
RCH Sep ‘24