So, how do we treat pneumonia?
Well, it depends on the child's age,
and their clinical and
First, infants and pre-school
aged children with a normal,
uncomplicated bacterial pneumonia
should be treated with Amoxicillin.
Amoxicillin's great for this.
It provides great coverage, it's inexpensive,
and has a low side effect profile.
Kids tolerate this very well.
In older children, with
uncomplicated bacterial pneumonia,
so this is >5 year olds, you should
start them on a macrolide treatment.
Community-acquired pneumonia - antibiotics
should be initiated immediately.
There should not be a
delay in treating the patient
because remember, these patients
are treated outpatient.
They're not receiving IV antibiotics.
So when they start their oral antibiotics,
it's going to take them about 24 hours until
the antibiotics actually start working,
and so, you don't want to delay this care.
Now, if your patient has a viral pneumonia,
they're going to be treated
with supportive care.
We're going to encourage rest, hydration.
They may need some supplemental
and anti-pyretics to manage fever as needed.
Remember, antibiotics are not
indicated with a viral infection.
Now, most pneumococcal infections are mild.
However, some can be deadly or result in
long-term complications such as hearing loss.
Another complication is bacteremia.
This is a type of invasive pneumococcal
disease that infects the blood.
About 1 out of every 100
children younger than 5
with this bloodstream
infection will die from it.
Now, this is a little bit
different from sepsis,
which is when bacteremia or another
infection triggers a massive,
This will initiate a fever,
weakness, a rapid heart rate,
rapid breathing rate, and ultimately,
a decreased blood pressure.
This is a life-threatening and
overwhelming response to a trigger
that can result in end or in failure,
ultimately killing the patient.
This is another complication of pneumonia,
and it is the most severe and evasive.
Of children younger than 5 who
get pneumococcal meningitis,
about 1 out of 15 will
die from this infection.
Others may have long-term problems such
as hearing loss or developmental delay.
This is an infection that develops
in the space between the membranes
that surround the lungs
and the chest cavity.
Sometimes, this will need to be drained.
This is an inflammation that
develops around the heart.
Atelectasis is a complete or partial
collapse of the entire lung
or the area, the whole lobe, of the lung,
and this can also happen in
the setting of pneumonia.
A pulmonary abscess can develop and this
is a collection of pus in the lungs.
Now, less serious would be a sinus infection.
These are usually mild, and it's
a pretty common complication,
as the bacteria can translocate.
Now, remember, the most common cause
of pneumonia is <i>Strep pneumoniae</i>,
and the most common cause of sinus
infections is also <i>Strep pneumoniae</i>.
These are mild complications,
but some children can develop recurring
infections requiring further intervention.