Uncomplicated Pneumonia - CPS Statement Flashcards
What is the most common bacterial cause of community-acquired pneumonia?
Streptococcus pneumoniae
Aside from S. pneumo, what are two other bacterial causes of pneumonia in school aged children?
Mycoplasma pneumoniae and Chlamydophila pneumoniae
How does Mycoplasma pneumoniae typically present?
M pneumoniae is typically characterized by malaise and headache for seven to 10 days before the onset of fever and cough, which then predominate.
As per the CPS statement, what are the two indications for drainage of pleural effusion?
Culture and drainage of a pleural effusion is indicated if the effusion is large and/or is clinically important as a cause for respiratory compromise or when response to medical therapy alone is not satisfactory.
What is the minimal acceptable blood volume for cultures in children/
the minimum volume of blood cultured should be at least:
- 1 mL to 2 mL in infants
- 4 mL to 5 mL in children <10 years of age
- 10 mL to 20 mL in older children
What are the potential indications for admission in a child with community acquired pneumonia?
Hospitalization is generally indicated if: - A child has inadequate oral intake
- Intolerant of oral therapy
- Has severe illness or respiratory compromise (eg, grunting, nasal flaring, apnea, hypoxemia)
- Pneumonia is complicated
What is the first line antibiotic management for uncomplicated community acquired pneumonia?
Ampicillin (IV) or amoxicillin (oral)
Provides good S. pneumo coverage
What is the benefit of ceftriaxone over ampicillin in children with septic shock or severe respiratory distress?
1) Offer better coverage than amoxicillin or ampicillin for beta-lactamase-producing H influenzae
2) May be more efficacious against high-level penicillin-resistant pneumococcus
3) Possibly provide empirical coverage for the rare methicillin-susceptible S aureus (a rare cause of pneumonia)
You have a child with community acquired pneumonia with a CXR that shows multilobar disease or pneumatoceles. What antibiotic should you add?
Vancomycin (in addition to CTX) to provide extra MRSA coverage
What antibiotic do you use to treat atypical pneumonia (i.e. mycoplasma or chlamydia)?
Macrolide antibiotic (azithromycin for five days or clarithromycin for 7 days)
You have a child with atypical pneumonia that you would like to treat with antibiotics, however they come from an area of Asia with high macrolide resistance. What is an alternative option?
Can also use doxcycline in children (in children age 8 or above)
If patients with suspected bacterial pneumonia do not respond to therapy within ___ h to ___ h, a chest radiograph should be obtained and a further clinical evaluation carried out
48 to 72 hrs
What is the duration of treatment for uncomplicated community-acquired pneumonia?
7 - 10 days
What is the duration of treatment for pneumonia complicated by abscess formation or empyema?
Usually 2 - 4 weeks
What is the recommend dose of amoxicillin for community acquired pneumonia?
40–90 mg/kg/day divided 3 times daily
