Table 4.

Empiric therapy for pediatric community-acquired pneumonia (CAP) – inpatient.

Site of Care (Inpatient).		Empiric Therapy for Presumed Bacterial Pneumonia			Empiric Therapy for Presumed Atypical Pneumonia			Empiric Therapy for Presumed Influenza Pneumonia
		Antibiotic	Route	Regimen	Antibiotic	Route	Regimen	Antiviral
Uncomplicated CAP.	Initial therapy	Ampicillin	IV	200 mg/kg/day divided every 6 hr.	Azithromycin	IV/PO	Given as a single daily dose; 10 mg/kg on day 1; 5 mg/kg on days 2 to ss 5	Oseltamivir
		Or Penicillin G	IV	250,000-400,000 U/kg/day divided every 4–6h
	Alternative	*Amoxicillin clavulanate	IV	90 mg/kg/day divided every 8 hr.	Clarithromycin	PO	15 mg/kg/day in 2 doses for 7–14 days.
		Or *Cefuroxime	IV	150 mg/kg/day divided every 8 hr.	Or Erythromycin	IV/PO	40mg/kg/day in 4 doses
Complicated CAP.		Ceftriaxone	IV	75mg/kg/day every 24 hr.	Same Empiric Therapy for Presumed Atypical Pneumonia in Uncomplicated Pneumonia.
		**Clindamycin	IV	40mg/kg/day divided every q8h
		Or**Vancomycin	IV	60mg/kg/day divided every q8h

Doses was adapted from 2017 Nelson's Pediatric Antimicrobial Therapy, 23rd Ed.

*Consider in children whom not completing Haemophilus influenzae type b (Hib) vaccines series (three doses).

** Consider if infection suspected due to community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) especially in cases of Necrotizing pneumonia, Sepsis, Concurrent skin infection due to MRSA, and/or Previous MRSA colonization. IV Intravenously; PO Orally.