Community Acquired Pneumonia v1

  • Birth – 20 days
    • Common: Perinatal acquired
      • Group B. streptococcus
      • Listeria monocytogenes
      • Gram negativr rods
        • E. coli
        • Klebsiella pneumonia
    • Less common
      • Nontypable H. influenza
      • Enterococci
      • Staph aureus
      • C. trachomatis (after 2 weeks)
    • Treatment
      • Inpatient:
        • Ampicillin IV plus
        • Gentamicin IV w or w/o
        • Cefotaxime IV
      • Outpatient:
        • None
  • 3 weeks – 3 months
    • Common
      • S. pneumoniae
      • S. aureus
      • H. influenza
      • Viruses: RSV, parainfluenza, influenza, HMV
    • Less Common
      • C. trachomatis (after 2 weeks)
      • Bordetella pertussis
      • perinatal acquired still possible
    • Treatment
      • Inpatient
        • Cefotaxime IV (< 4-6 weeks) or Ceftriaxone plus
          • Azithromycin 10 mg/kg
        • If concern for MHSA Vancomycin
        • Consider antivirals if concern for influenza
      • Outpatient
        • < 3 month consider admission
        • AMoxicillin 80-90 mg/kg divided BID x 10 days
        • If pcn allergy:
          • Consider Cephalosporin and/or Azithromycin
        • Follow-up 24 – 48 hours
  • 3 months – 5 years
    • Common
      • Viruses: RSV, parainfluneza, influenza
      • S. pneumo
      • S. pyogenes
      • S. aureus
    • Less Common
      • M. Pneumonia
      • C. Pneumonia
    • Treatment
      • Inpatient
        • Cefotaxime IV (< 4-6 weeks) or Ceftriaxone plus
          • Azithromycin 10 mg/kg
        • If concern for MHSA Vancomycin
        • Consider antivirals if concern for influenza
      • Outpatient
        • < 3 month consider admission
        • AMoxicillin 80-90 mg/kg divided BID x 10 days
        • If pcn allergy:
          • Consider Cephalosporin and/or Azithromycin
        • Follow-up 24 – 48 hours
  • 5 years – Adolescent
    • Common
      • M. pneumonia
      • C. pneumonia
      • S. pneumonia
      • S. pyogenes
      • Viruses: influenza
    • Treatment
      • Inpatient
        • Ceftriaxone IV plus
          • Azithromycin
        • Consider antivirals for influenza
      • Outpatient
        • Azithromycin
        • Antivirals if high risk
        • Follow-up 24 – 48 hours

Leave a Comment