00:01
So, how do we treat pneumonia?
Well, it depends on the child's age,
and their clinical and
epidemiologic factors.
00:08
First, infants and pre-school
aged children with a normal,
uncomplicated bacterial pneumonia
should be treated with Amoxicillin.
00:16
Amoxicillin's great for this.
00:18
It provides great coverage, it's inexpensive,
and has a low side effect profile.
00:23
Kids tolerate this very well.
00:25
In older children, with
uncomplicated bacterial pneumonia,
so this is >5 year olds, you should
start them on a macrolide treatment.
00:34
Community-acquired pneumonia - antibiotics
should be initiated immediately.
00:39
There should not be a
delay in treating the patient
because remember, these patients
are treated outpatient.
00:44
They're not receiving IV antibiotics.
00:47
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.
00:56
Now, if your patient has a viral pneumonia,
they're going to be treated
with supportive care.
01:01
We're going to encourage rest, hydration.
01:04
They may need some supplemental
oxygen support
and anti-pyretics to manage fever as needed.
01:10
Remember, antibiotics are not
indicated with a viral infection.
01:15
Now, most pneumococcal infections are mild.
01:17
However, some can be deadly or result in
long-term complications such as hearing loss.
01:23
Another complication is bacteremia.
01:25
This is a type of invasive pneumococcal
disease that infects the blood.
01:29
About 1 out of every 100
children younger than 5
with this bloodstream
infection will die from it.
01:35
Now, this is a little bit
different from sepsis,
which is when bacteremia or another
infection triggers a massive,
body-wide response.
01:43
This will initiate a fever,
weakness, a rapid heart rate,
rapid breathing rate, and ultimately,
a decreased blood pressure.
01:52
This is a life-threatening and
overwhelming response to a trigger
that can result in end or in failure,
ultimately killing the patient.
02:01
Now, meningitis.
02:03
This is another complication of pneumonia,
and it is the most severe and evasive.
02:07
Of children younger than 5 who
get pneumococcal meningitis,
about 1 out of 15 will
die from this infection.
02:13
Others may have long-term problems such
as hearing loss or developmental delay.
02:19
And empyema.
02:20
This is an infection that develops
in the space between the membranes
that surround the lungs
and the chest cavity.
02:26
Sometimes, this will need to be drained.
02:29
Pericarditis.
02:31
This is an inflammation that
develops around the heart.
02:36
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.
02:46
A pulmonary abscess can develop and this
is a collection of pus in the lungs.
02:51
Now, less serious would be a sinus infection.
02:53
These are usually mild, and it's
a pretty common complication,
as the bacteria can translocate.
02:59
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>.
03:07
Ear infections.
03:08
These are mild complications,
but some children can develop recurring
infections requiring further intervention.