Community acquired pneumonia

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Observation without antibiotics is an option for younger children with community acquired pneumonia(CAP) managed outpatient.

While most pediatric pneumonia is viral the most common “Typical” bacterial pathogens seen in epidemiology studies of pediatric pneumonia is Streptococcus pneumoniae followed by Group A Streptococcus and Staphylococcus Aureus. The "atypical" pathogen Mycoplasma pneumoniae becomes more common as children get older.

Amoxicillin is first line for healthy vaccinated infants and young children directed primarily at S pneumoniae. For young children without severe disease the IDSA states, “Antimicrobial therapy is not routinely required for preschool-aged children with CAP, because viral pathogens are responsible for the great majority of clinical disease.”

References:

Bradley JS, Byington CL, Shah SS, Alverson B, Carter ER, Harrison C, Kaplan SL, Mace SE, McCracken GH Jr, Moore MR, St Peter SD, Stockwell JA, Swanson JT; Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. The management of community-acquired pneumonia in infants and children older than 3 months of age: clinical practice guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. Clin Infect Dis. 2011 Oct;53(7):e25-76. PMID: 21880587

Jain S, Williams DJ, Arnold SR, Ampofo K, Bramley AM, Reed C, Stockmann C, Anderson EJ, Grijalva CG, Self WH, Zhu Y, Patel A, Hymas W, Chappell JD, Kaufman RA, Kan JH, Dansie D, Lenny N, Hillyard DR, Haynes LM, Levine M, Lindstrom S, Winchell JM, Katz JM, Erdman D, Schneider E, Hicks LA, Wunderink RG, Edwards KM, Pavia AT, McCullers JA, Finelli L; CDC EPIC Study Team. Community-acquired pneumonia requiring hospitalization among U.S. children. N Engl J Med. 2015 Feb 26;372(9):835-45. PMID: 25714161