Pneumonia, community acquired (mild to moderate)

amoxicillin po, see dosing table below, for 3 days.

For penicillin allergy (non-severe and severe) OR in patients where atypical pneumonia is suspected* AND admission to hospital is warranted for respiratory support:

* over 5 years old, non-response to beta-lactams, duration of symptoms more than 6 days, low inflammatory markers AND admission to hospital is warranted for respiratory support: 

Under 6 months: clarithromycin po, see dosing table below, for 3 days 

6 months and over: azithromycin 10mg/kg (max 500mg) po OD for 3 days

• Explain to parents or carers that after starting treatment their child's symptoms should steadily improve, although the rate of improvement will vary and some symptoms will persist after stopping antibiotics. For most children:

 • fever (without use of antipyretics) and difficulty breathing should have resolved within 3 to 4 days

• cough should gradually improve but may persist for up to 4 weeks after discharge and does not usually require further review if the child is otherwise well

• Advise parents or carers of children with community-acquired pneumonia to seek further advice if there is persisting fever combined with:

 • increased work of breathing, or,

• reduced fluid intake for children or poor feeding for infants, or,

• unresolving fatigue.

• Give advice to people with community-acquired pneumonia (or their parents or carers, if appropriate) about:

• possible adverse effects of the antibiotic(s)

• seeking further advice (if the person is receiving treatment in the community or via hospital at home service) if:

• • • symptoms worsen rapidly or significantly, or,
    • symptoms do not start to improve within 3 days, or,
    • the person becomes systemically unwell.