Intravenous therapy for moderate-severity CAP in children 2 months or older
For children 2 months or older with moderate-severity CAP who can tolerate and absorb oral therapy, use oral therapy because studies have shown equivalent outcomes to intravenous therapyAddo-Yobo, 2004Atkinson, 2007Hazir, 2008.
For children 2 months or older with moderate-severity CAP who cannot tolerate or absorb oral therapy, use:
benzylpenicillin 50 mg/kg up to 1.2 g intravenously, 6-hourly. See advice on patient review, intravenous to oral switch and duration of therapy. benzylpenicillin
For children 2 months or older with moderate-severity CAP who have had a nonsevere (immediate or delayed) hypersensitivity reaction to a penicillin, use:
1cefotaxime 50 mg/kg up to 2 g intravenously, 8-hourly. See advice on patient review, intravenous to oral switch and duration of therapy cefotaxime
OR
1ceftriaxone 50 mg/kg up to 2 g intravenously, daily. See advice on patient review, intravenous to oral switch and duration of therapy. ceftriaxone
For children 2 months or older with moderate-severity CAP who have had a severe immediate1 hypersensitivity reaction to a penicillin, cefotaxime or ceftriaxone (at the dosage above) can be considered if a beta-lactam antibiotic is strongly preferred (for considerations, see Severe immediate hypersensitivity: Implications of cross-reactivity between penicillins and cephalosporins).
For children 2 months or older with moderate-severity CAP who have had a severe immediate1 hypersensitivity reaction to a penicillin in whom cefotaxime or ceftriaxone is not used, or for children who have had a severe delayed2 hypersensitivity reaction to a penicillin, use:
azithromycin 10 mg/kg up to 500 mg intravenously, daily. See advice on patient review, intravenous to oral switch and duration of therapy. azithromycin