Empirical therapy for suspected Chlamydia trachomatis late-onset CAP in term neonates and CAP in children younger than 2 months

If Chlamydia trachomatis is suspected (eg afebrile children with ‘staccato’ cough [single coughs separated by inspiration], children with diffuse crackles on auscultation, presence of conjunctivitis) in term neonates with late-onset CAP (occurring more than 72 hours after birth) and children younger than 2 months with CAP, add azithromycin to the empirical therapy regimen. Use:

Neonates with C. trachomatis pneumonia may also have chlamydial conjunctivitis – for management, see Chlamydial conjunctivitis.

Neonates with C. trachomatis pneumonia are presumed to have been infected perinatally from their birthing parent (eg mother). Treat the birthing parent for C. trachomatis infection – for treatment regimens, management of sexual contacts and other information, see Approach to Chlamydia trachomatis infectionPalasanthiran, 2022.