Initial management of suspected CAP in neonates and children younger than 2 months

For neonates and children younger than 2 months, acute viral bronchiolitis is the most likely differential diagnosis of community-acquired pneumonia (CAP) in those who present with cough and respiratory distress; see Acute bronchiolitis.

In neonates and children younger than 2 months, the clinical signs of serious infection are usually nonspecific. Therefore, unless all features suggest a diagnosis of acute viral bronchiolitis, treat suspected CAP as for sepsis or septic shock until relevant differential diagnoses (eg meningitis and encephalitis) are excluded – see Sepsis or septic shock of unknown source in neonates and children younger than 2 months for advice on initial management, including empirical antibiotic regimens.

Note: Unless acute viral bronchiolitis is a more likely diagnosis, use the antibiotic regimens for sepsis or septic shock as initial management of suspected CAP in neonates and children younger than 2 months.

If the neonate or child younger than 2 months is improving on the empirical regimen for sepsis or septic shock, the ongoing empirical regimens in this topic can be used once meningitis and encephalitis are excluded. If the patient is not improving, seek expert advice for management.