- Preschool children (Streptococcus pneumoniae · respiratory viruses · Haemophilus influenzae)
- School-age children (Streptococcus pneumoniae · Mycoplasma pneumoniae · Chlamydia pneumoniae)
First-line therapy
Amoxicillin • p.o. • 80–90 mg/kg/day • 2×/day
Max 4000 mg/day · Duration: 5–10 days · Minimum 5 days; extend if not clinically improved
Enter weight on Kids to calculate doses
Amoxicillin/clavulanate • p.o. • 80–90 mg/kg/day • 2×/day
Dose is calculated using the amoxicillin component.
Max 4000 mg/day · Duration: 5–10 days
- • Amoxicillin/clavulanate: recent amoxicillin, beta-lactam failure, or suspected beta-lactamase organisms — 80–90 mg/kg/day PO 2×/day (amoxicillin component)
- • Cefuroxime axetil: non-Type I beta-lactam allergy or intolerance — 30 mg/kg/day PO 2×/day (max 1 g/day), 5–10 days
- • Azithromycin: atypical pathogens suspected in school-age children — 10 mg/kg PO day 1, then 5 mg/kg/day days 2–5 (max 500 mg/day)
- • Clarithromycin: atypical pathogens suspected — 15 mg/kg/day PO 2×/day (max 1 g/day), 5–10 days
Clinical notes
- • Viral pneumonia does not routinely require antibiotics.
- • Consider atypical pathogens in school-age children.
- • Reassess after 48–72 hours if no clinical improvement.
- • High-dose amoxicillin is first-line for outpatient bacterial CAP.
- • PIDS/IDSA Clinical Practice Guideline — Pediatric CAP (2011)
- • ESPID Guideline (2024)
- • WHO Pocket Book of Hospital Care for Children (2022)
+ 1 more
- • NICE NG122 — Pneumonia in Adults (principles applicable) (2019)
