Review of children 2 months or older with moderate-severity CAP

Once treatment for moderate-severity CAP has started, the child’s symptoms should steadily improve. The rate of recovery is influenced by the severity of pneumonia and the child’s general health and comorbidities. Fever should subside within the first few days of appropriate antibiotic therapy and appetite should improve. Cough, sputum production (if present), chest discomfort and breathlessness may take several weeks to resolve. Children can experience fatigue for months after an episode of pneumonia.

Complications of pneumonia such as lung abscess, parapneumonic effusion and empyema can occur in children. If the child’s clinical syndrome does not resolve as expected with appropriate antibiotic therapy, investigate for complications of pneumonia. For management of complications of pneumonia, see Lung abscess or Parapneumonic effusion and thoracic empyema, and for advice on investigations for alternative diagnoses, see Approach to managing children 2 months or older with CAP who are not improving.

If available, modify treatment based on the results of investigations, including susceptibility testing – see Directed therapy for pneumonia.