LRT Infections - Pediatrics Flashcards
The younger the child. the higher/lower their respiratory rate?
Higher
Normal respiratory rate in age >5 years is ___
> 20 bpm
3 typical pathogens in pediatric CAP are:
- S. pneumoniae
- H. influenzae
- M. catarrhalis
Atypical CAP usually has an abrupt/gradual presentation and is ___ common in kids <5
abrupt presentation and less common in kids <5
Infants and children with CAP should be admitted if their oxygen level is
<90%, considered moderate to severe CAP
First line inpatient therapy for FULLY IMMUNIZED children with presumed bacterial CAP
Ampicillin or penicillin G
Alternative inpatient therapy for FULLY IMMUNIZED children with presumed bacterial CAP
ceftriaxone or cefotaxime
First line inpatient therapy for FULLY IMMUNIZED AND NON FULLY-IMMUNIZED children with presumed atypical CAP
azithromycin
First line inpatient therapy for NON FULLY IMMUNIZED children with presumed bacterial CAP
ceftriaxone or cefotaxime
What should be added for suspected CA-MRSA for presumed bacterial CAP
vancomycin or clindamycin
First line outpatient therapy for presumed bacterial CAP in children <5 years
High-dose amoxicillin (90 mg/kg/day divided q12h)
First line outpatient therapy for presumed atypical CAP in all children
azithromycin (10 mg/kg/day x 1 day, then 5 mg/kg/day x 4 days)
First line outpatient therapy for presumed bacterial CAP in children ≥5 years
high-dose amoxicillin +/- azithromycin
Therapy for influenza CAP (viral)
oseltamivir
These two LRI in children are caused by viruses
croup, bronchiolitis
Age range for croup
6 months-6 years
Episode duration of croup
~1 week
Airway management in croup
sitting upright is better than laying down, if severe inflammation in epiglottis, need to get immediate medical attention
Supportive care in croup and bronchiolitis
humidified air, hydration, oxygen supplementation (in hospital)
Croup therapy
Dexamethasone given IM (NOT INHALED) or epinephrine via nebulizer
Acute viral infection causing inflammation, edema, increased mucus production, and bronchospasm of lower respiratory tract
bronchiolitis
Age most common for bronchiolitis
Children <1 year
For which treatment do physicians perform chest physiotherapy?
bronchiolitis to try and break up mucus in CF patients
RSV prevention prophylaxis
palivizumab 15 mg/kg/dose IM qmonth (3-5 total doses during RSV season)
Palivizumab can be given to any child for RSV prevention (T/F)
False, only for high risk patients
Palivizumab should be given to premature infants born
<29 weeks GA and less than 12 months of age at start of RSV season
CF patients are candidates for RSV prevention palivizumab (T/F)
False, only if they have another condition that qualifies them
The greatest mortality and complications of pertussis is in infants
<6 months
Pertussis treatment
azithromycin 10 mg/kg/day x 5 days for 0-5 months
Bactrim is contraindicated in children age ___ for pertussis
<2 months
Who are candidates for pertussis post-exposure prophylaxis?
- Infants and women in 3rd trimester of pregnancy
- pre-existing health conditions that may be exacerbated by pertussis
- Persons in close contact with infants <12 months, pregnant women, high risk individuals
In CF, you should use a _-drug approach to double cover for pseudomonas
2-drug approach (beta-lactam + aminoglycoside or fluoroquinolone)
Outpatient therapy for CF
PO + increased CPT, IV +/- PO + CPT
Inpatient therapy for CF
IV +/- PO + increased CPT
MRSA coverage in CF
vancomycin (IV) or Bactrim (IV/PO)
Pseudomonas coverage in CF
Pip-tazo (IV) + AG, cefepime (IV) + AG
