The most likely etiologic agents and treatment of CAP in children are based on age.
Diagnosis
-History and physical consistent with CAP.
-Diagnosis based mainly on H&P.
-Fever + respiratory signs and symptoms (cough, tachypnea).
-Vital signs: RR, Oxygen sats, and HR, Temp, BP.
-Pneumonia severity assessed.
-CXR and Labs as needed.
-Viral testing as needed.
Treatment
-Will monitor respiratory rate and effort.
-Continuous pulse oximetry (if inpatient).
-The decision of treatment setting (outpatient vs. inpatient) discussed.
–Antibiotic choices discussed.
-Immunization with the PCV-13 vaccine (reduces the severity of childhood pneumococcal infections).
—//—
“Amoxicillin is the recommended first-line treatment for previously healthy infants and school-age children with mild to moderate community-acquired pneumonia (CAP). The most prominent bacterial pathogen in CAP in this age group is Streptococcus pneumoniae, and amoxicillin provides coverage against this organism.
Azithromycin would be an appropriate choice in an older child because Mycoplasma pneumoniae would be more common.
Ceftriaxone and cefdinir can both be used to treat CAP, but they are broader spectrum antibiotics and would not be a first-line choice in this age group.”
—-
Presentation: Cough, fever, and increased RR. Young infants and children may have decreased feeding.
On PE, check how the kid looks, consolable or not. Vitals. Mucous membranes, respiratory effort, and rate. Etc.
Which one of the following is the best initial treatment for this child? Answer: High-dose oral amoxicillin
Reference
Am Fam Physician 2012;86(7):661-667.