PCAP CPG Flashcards
What are the clinical signs and symptoms that accurately diagnose community-acquired pneumonia in infants and children aged 3 months to 18 years?
Cough or fever, PLUS any of the following positive predictors:
* Tachypnea
* Retractions or chest indrawing
* Nasal flaring
* O2 saturation <95% at room air
* Grunting
Tachypnea thresholds vary by age group.
What is the tachypnea threshold for infants aged 3 to 12 months?
≥50 breaths per minute
What is the tachypnea threshold for children aged 1 to 5 years?
≥40 breaths per minute
What is the tachypnea threshold for children aged 5 to 12 years?
≥30 breaths per minute
What is the tachypnea threshold for children aged over 12 years?
≥20 breaths per minute
What clinical and ancillary parameters determine the need for admission in infants and children with community-acquired pneumonia?
Clinical parameters include:
* Respiratory signs
* Central Nervous System signs
* Circulatory signs
* General considerations
* Ancillary parameters
Different parameters are assessed based on severity.
In the 2021 PCAP CPG, what is the respiratory sign threshold for severe pneumonia in children aged 3 to 12 months?
> 60/min to ≤70/min
What is the general consideration for malnutrition in non-severe pneumonia according to 2021 PCAP CPG?
None or mild
What ancillary parameter is used to assess oxygen saturation in children with pneumonia?
Oxygen saturation at room air using pulse oximetry for 20-30 minutes
What is the recommended oxygen saturation threshold for admission in the 2021 PCAP CPG?
≥94%
What diagnostic aid is strongly recommended for severe community-acquired pneumonia in a hospital setting?
Chest X-ray
What is the role of procalcitonin (PCT) in diagnosing bacterial pneumonia?
Recommended to be used in conjunction with other factors such as clinical presentation and imaging modalities
True or False: Routine diagnostic aids are considered for non-severe pneumonia in an ambulatory setting.
False
What are the parameters suggestive of bacterial etiology for antibiotic treatment in pneumonia?
- Elevated white blood cell count (WBC)
- Elevated C-reactive protein (CRP)
- Elevated procalcitonin (PCT)
- Imaging findings such as alveolar infiltrates or unilateral consolidation
These parameters apply to both non-severe and severe pneumonia.
What is the recommended empiric treatment for non-severe pneumonia?
Options include:
* Amoxicillin trihydrate
* Amoxicillin-clavulanate
* Cefuroxime
Dosing varies based on age and severity.
What is the recommended empiric treatment for severe pneumonia?
Options include:
* Penicillin G
* Ampicillin
* Cefuroxime
* Ceftriaxone
* Ampicillin-sulbactam
* Clindamycin
* Vancomycin for severe cases
Dosing and selection depend on vaccination status and local resistance data.
What is the significance of chest X-ray findings in severe pneumonia?
Findings of effusion, abscess, air leak, or multilobar consolidation indicate severe pneumonia.
What clinical signs indicate the need for admission in severe pneumonia?
Signs include:
* Cyanosis/Hypoxemia
* Altered sensorium
* Poor perfusion
* Severe malnutrition
These signs help assess the severity and need for intervention.
Fill in the blank: Empiric antibiotic therapy is considered to be started in patients with clinical signs and symptoms of pneumonia with _______ suggestive of bacterial etiology.
[ANY parameters]
What is the preferred dosage of Vancomycin?
40-60 mg/kg/day Q6 to Q8
What empiric treatment is effective for infants and children aged 3 months to 18 years with community-acquired pneumonia if a bacterial etiology is considered?
Cefuroxime or Ceftriaxone
What is the dosage for Cefuroxime in patients with non-type 1 hypersensitivity to Penicillin?
PO 20-30mg/kg/day Q12 or IV 100-150mg/kg/day Q8
What is the recommended treatment for patients with type 1 hypersensitivity to Penicillin?
Azithromycin, Clarithromycin, or Clindamycin
What is the dosage for Azithromycin in patients with type 1 hypersensitivity?
10mg/kg/day PO or IV Q24 for 3 days or 10mg/kg/day on day 1 followed by 5 mg/kg/day Q24 for days 2 to 5
