Prevention Prevention
ÎChildren should be immunized with vaccines for bacterial pathogens including S. pneumoniae, Haemophilus influenzae type b, and pertussis to prevent CAP. (SR-H)
ÎAll children and adolescents 6 months of age and older should be immunized annually with vaccines for influenza virus to prevent CAP. (SR-H)
ÎParents and caretakers of infants less than six months of age, including pregnant adolescents, should be immunized with vaccines for influenza virus and pertussis to protect the infants from exposure. (SR-L)
ÎPneumococcal CAP following influenza virus infection is decreased by immunization against influenza virus. (SR-L)
ÎHigh-risk infants should be provided immune prophylaxis with RSV- specific monoclonal antibody to decrease the risk of severe pneumonia and hospitalization caused by RSV. (SR-H)
Table 4. Selection of Antimicrobial Therapy for Specific Pathogens
Pathogen
S. pneumoniae with MIC values to penicillin ≤ 2.0 mcg/mL
Parenteral Therapy
Preferred: • Ampicillin (150-200 mg/kg/day div q6h) or
• Penicillin
(200,000-250,000 units/kg/day div q4-6h)
Alternatives: • Ceftriaxone (50-100 mg/kg/day div
• Cefotaxime (150 mg/kg/day div q8h)
q12-24h) (Preferred for parenteral outpatient therapy) or
May also be effective: • Clindamycin (40 mg/kg/day div q6-8h) or
• Vancomycin (40-60 mg/kg/day div q6-8h)
Alternatives: • A second or third generation cephalosporin (cefpodoxime, cefuroxime, cefprozil)
(Step-Down Therapy or Mild Infection)
Oral Therapy
Preferred: • Amoxicillin (90 mg/kg/day div bid)
• Levofloxacin PO, if susceptible (16-20 mg/kg/day div bid for children 6 mo to 5 y and 8-10 mg/kg once daily for children 5 to 16 y; max daily dose, 750 mg) or
• Linezolid PO (30 mg/kg/day div tid for children < 12 y and 20 mg/kg/day div bid for children ≥ 12 y)
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