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Pneumonia in children

Posted Jan 29 2010 1:20pm

The effectiveness of treatment and options of initial therapy of community-acquired pneumonia in children

The optimum effect of the treatment

An effective antibiotic, not requiring the replacement should be considered one on the background of which within 24-48 hours (with uncomplicated pneumonia) and 72 hours (complicated):

  • the temperature drops to normal or subfebril
  • the general condition is improving;
  • respiration rate and heart rate decrease.


The presence of these signs indicates a favorable course of the disease and good prognosis. Typically, 2-3 days later there is a positive dynamics of the physical, and subsequently the X-ray data.

How to choose an antibiotic for community-acquired pneumonia treatment in children?

To select the right antibiotic against pneumonia, it is required to know the age of the child and the causative agent.

Children aged 1 to 6 months

At this age, children most frequently found to have E. coli, staphylococcus, Chlamidia trachomatis (50% of all pneumonia). With this regard, the first choice antibiotics should be considered penicillin drugs, and if there is a suspect on the Escherichia coli, it is recommended to use ampicillin with gentamicin. In addition, the drugs of choice may be cephalosporins. In lighter cases, protected penicillins (oral) are effective as well.

Children aged 6 months to 6 years

At this age in pneumococcus, rarely Pfeiffer’s bacillus and mycoplasma dominate in the etiology of acute pneumonia. In the case of an uncomplicated course, it is possible to use penicillins (amoxicillin, amoxicillin / clavulanate, amoxicillin / sulbactam), macrolides (sumamed, erythromycin), cephalosporins. If in 24-36 hours there is no effect, the drugs should be changed. If atypical pneumonia (caused by mycoplasma) is suspected, macrolides should be prescribed.

Children aged 6 to 15 years

Pneumonia in this age range is often caused by pneumococci and atypical pathogens (mycoplasma, chlamydia). In the case of the typical pneumonia the initial antibiotics may be:

  • Penicillins protected, resistant to beta-lactamase: amoxicillin / clavulanate ( Augumentin ), ampicillin / sulbactam, piperacillin
  • Penicillins unprotected
  • First generation cephalosporins (cephalexin)

If there is no therapeutic effect in 24-36 hours, the drug should be replaced by III generation cephalosporins or vancomycin (in suspect of resistant pneumococci). If in this case, the therapy is unsuccessful, it must be assumed atypical etiology of pneumonia caused by mycoplasma, chlamydia, legionella. In this situation, the drugs of choice are macrolides.

Besides amoxicillin and other antibiotics, the alternative options for the pneumonia treatment include: water schedule, expectorant therapy, air therapy, thermal procedures and others.

Thus, if pneumonia is diagnosed in time and treated with the right antibiotics, the relief of the lung inflammation occurs in 8-10 days.

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