Patient handout

Pediatric community-acquired pneumonia

PRODUCTION

1. Your condition

This handout is for pediatric community-acquired pneumonia. Your care team identified this based on: fever + cough + age-band tachypnea in a child (idsa/pids 2011 pmid 21880587).

Other reasons your team may use this plan: retractions, nasal flaring, grunting, accessory-muscle use, head-bobbing (who imci severity); new infiltrate on cxr or consolidation on lung ultrasound (idsa/pids 2011 pmid 21880587); spo2 <90-92% in a child with respiratory illness — admission threshold (idsa/pids 2011 pmid 21880587).

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
ampicillin	Neonate 150-300 mg/kg/day IV divided q6-8h (age/weight-banded); covers GBS + Listeria	IV	q6-8h	GBS + Listeria coverage in the neonatal CAP/sepsis overlap; pair with an aminoglycoside or 3GC. RxCUI 733 = ampicillin RxNav-verified IN 2026-05-16
gentamicin	Neonate 4-5 mg/kg/dose IV (gestational-age/postnatal-age interval)	IV	q24-36h by GA/PNA	Gram-negative synergy with ampicillin in neonatal sepsis/pneumonia (route id.sepsis.core.v1). RxCUI 4128 = gentamicin RxNav-verified IN 2026-05-16
ceftriaxone	50-75 mg/kg/day IV (AVOID <28 d if hyperbilirubinemia or calcium-containing IV — use cefotaxime)	IV	daily	Alternative gram-negative cover beyond the neonatal period; ceftriaxone bilirubin/calcium caution in neonates. RxCUI 2193 = ceftriaxone RxNav-verified IN 2026-05-16

Plan: IDSA/PIDS pediatric CAP — weight-based ladder (outpatient → ward → PICU); age-tiered; short-course-evidenced

3. When to call your provider

Contact your care team if any of the following happen:

oxygen level (SpO₂) <90-92% → admit (IDSA/PIDS 2011 PMID 21880587)
Inability to tolerate PO / dehydration → admit
No improvement at 48-72 h on first-line → admit / step up
Neonate/<3 mo with fever → ED + sepsis workup (route id.sepsis.core.v1)

4. When to seek emergency care

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

oxygen level (SpO₂) <90-92% on room air in pediatric CAP — strongest single severity marker; admission threshold
WHO SEVERE pneumonia — chest indrawing, inability to feed/drink, cyanosis, lethargy/AMS, or convulsions
Same WHO severity grade carries HIGHER mortality in the malnourished / HIV-infected / LMIC child — severity-mortality is CONDITIONAL on nutritional/immune status (do-not-read-in-isolation)
Pediatric CAP with sepsis-induced hypotension / cold or warm shock features(life-threatening)
Apnoea, grunting, or extreme bradypnea in an infant with CAP (esp. RSV / pertussis co-presentation)(life-threatening)
Moderate-large parapneumonic effusion or empyema on ultrasound/CT (loculation, thick fluid, persistent fever despite appropriate antibiotics)
Cavitation on imaging or persistent fever/toxicity despite adequate antibiotics
Neonate <28 d (or young infant <3 mo with toxicity) with fever and respiratory signs
Sickle cell disease child with fever + cough + new infiltrate + chest pain ± hypoxia — acute chest syndrome, a DISTINCT entity that mimics/overlaps pediatric CAP

5. Follow-up

Pneumococcal (PCV) + Hib + influenza + COVID catch-up immunisation review (Griffin PMID 23841730 — PCV materially cut hospitalisation); household smoke-exposure cessation; immunodeficiency / aspiration / structural workup if recurrent or non-resolving pneumonia; CXR follow-up at 4-6 wk ONLY for round/lobar/necrotising or non-resolving pneumonia — not routine if clinically resolved (IDSA/PIDS 2011 PMID 21880587)

6. Sources

Guideline: IDSA/PIDS 2011 Pediatric CAP Guideline (Bradley, Clin Infect Dis 2011;53(7):e25-76; PMID 21880587; DOI 10.1093/cid/cir531) + CAP-IT (Bielicki JAMA 2021) + SAFER (Pernica JAMA Peds 2021) short-course evidence + WHO IMCI severity pathway + Surviving Sepsis Pediatrics 2020