Treatment
Table 6. Empiric Therapy for Pediatric CAP (For children with drug allergy to recommended therapy, please see full text Guidelinesa
)
Site of Care Outpatient
< 5 y of age (preschool)
Empiric Therapy for Presumed Bacterial Pneumonia
Amoxicillin PO (90 mg/kg/day div bidb
)
Alternative: • Amoxicillin/ clavulanate PO (amox component, 90 mg/kg/day div bidb
) ≥ 5 y of age
Amoxicillin PO (90 mg/kg/day div bidb
4 g/dayc
For children with presumed bacterial CAP who do not have clinical, laboratory, or radiographic evidence that distinguishes bacterial CAP from atypical CAP, a macrolide can be added to a β-lactam antibiotic for empiric therapy
to a max of )
Alternative: • Amoxicillin/ clavulanate PO (amox component, 90 mg/kg/day div bidb
of 4 g/day, eg, one 2-g tablet bidb
to a max dose )
Empiric Therapy for Presumed Atypical Pneumonia
Azithromycin PO (10 mg/kg on day 1, followed by 5 mg/kg once daily on days 2-5)
Alternatives: • Clarithromycin PO (15 mg/kg/day div bid × 7-14 days) or
• Erythromycin PO (40 mg/kg/day div qid)
Azithromycin PO (10 mg/kg on day 1, followed by 5 mg/kg once daily on days 2-5 to a max of 500 mg on day 1, followed by 250 mg on days 2-5)
Oseltamivir or zanamivir (for children ≥ 7 y)
Empiric Therapy for Presumed Influenza Pneumonia
(see Table 5 for dosages)
Oseltamivir
Alternatives: • Clarithromycin PO (15 mg/kg/day div bid to a max of 1 g daily)
• Erythromycin; doxycycline for children > 7 y
Alternatives: • IV peramivir, IV oseltamivir and IV zanamivir are under clinical investigation in children
(IV zanamivir is available for compassionate use)
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