Patient handout

Pediatric community-acquired pneumonia (CAP)

PRODUCTION

1. Your condition

This handout is for pediatric community-acquired pneumonia (cap). Your care team identified this based on: fever + cough + age-band tachypnea in a child (pids/idsa 2011 bradley; who imci 2025).

Other reasons your team may use this plan: retractions / nasal flaring / grunting / accessory muscle use (who imci 2025; bts 2024); spo2 <92% in a child with respiratory illness (pids/idsa 2011; bts 2024); new infiltrate on cxr or consolidation on lung ultrasound (pids/idsa 2011; bts 2024).

2. Your medications

Take these medications exactly as prescribed. Do not stop or change a dose without talking to your provider.

Medication	Starting dose	How	When	What it does
amoxicillin	90 mg/kg/day PO divided BID or TID (max 4 g/day)	PO	q8-12h × 5 days	PIDS/IDSA 2011 first-line; high-dose covers DRSP; CAP-IT 2021 validated 3-day course in mild, 5-day standard
azithromycin	10 mg/kg PO day 1 (max 500 mg) then 5 mg/kg/day (max 250 mg) days 2-5	PO	daily × 5 days	Reserved for severe β-lactam allergy or atypical concern; macrolide resistance up to 10-20% in some regions

Plan: PIDS/IDSA pediatric CAP empiric antibiotics — outpatient → ward → PICU; age + immunization + severity-tiered (PIDS/IDSA 2011 Bradley + 2024 update; WHO IMCI 2025; BTS 2024)

3. When to call your provider

Contact your care team if any of the following happen:

oxygen level (SpO₂) <92% → admit (PIDS/IDSA 2011)
Inability to tolerate PO / dehydration → admit (PIDS/IDSA 2011)
Worsening at 48-72 h despite first-line abx → admit / step up (PIDS/IDSA 2011)
Age <3 mo with fever ≥38°C → ED + sepsis workup per peds.febrile-infant.core.v1 (AAP 2021 Pantell)
Apnea / seizure / AMS → ED + admit (WHO IMCI 2025)

4. When to seek emergency care

Call 911 or go to the nearest emergency room right away if you have:

oxygen level (SpO₂) <92% on room air in pediatric CAP — PIDS/IDSA 2011 admission threshold; LR+ ~3-5 for severe disease
Pediatric CAP with sepsis-induced hypotension / shock features — abnormal capillary refill / mottled / cold extremities / altered mental status / hypotension for age (SSC Pediatrics 2020)(life-threatening)
Apnea / extreme bradypnea in an infant with CAP — particularly RSV / pertussis co-infection (PIDS/IDSA 2011; AAP 2014 Ralston)(life-threatening)
Moderate-large parapneumonic effusion or empyema on CXR / ultrasound / CT — complicated CAP (PIDS/IDSA 2011; BTS 2024)
Cavitation / pneumatocele / necrotizing features on imaging or persistent fever despite appropriate abx (PIDS/IDSA 2011; BTS 2024)
Age <3 mo with fever ≥38°C rectal and respiratory illness — route to peds.febrile-infant.core.v1 sepsis pathway (AAP 2021 Pantell)
WHO IMCI severe pneumonia — central cyanosis OR inability to feed/drink OR persistent vomiting OR AMS / convulsions / lethargy OR severe respiratory distress (head nodding, grunting, severe chest indrawing) (WHO IMCI 2025)
Lung abscess on imaging — cavitary lesion with air-fluid level (PIDS/IDSA 2011; BTS 2024)

5. Follow-up

PCP follow-up 1-2 wk; CXR at 4-6 wk for round / lobar / non-resolving pneumonia (BTS 2024); immunization catch-up (PCV / Hib / influenza / COVID) per ACIP 2025; smoke-exposure cessation; immunology workup if recurrent / non-resolving; pulmonology referral if structural concern (PIDS/IDSA 2011; AAP Bright Futures)

6. Sources

Guideline: PIDS/IDSA 2011 pediatric CAP guideline (Bradley) + 2024 short-course update (CAP-IT 2021) + WHO IMCI 2025 + BTS 2024 pediatric pneumonia + SSC Pediatrics 2020/2024 + AAP 2021 Pantell febrile infant (neonatal routing)