Amoxicillin for Pediatric Pneumonia

Age-Specific Recommendations

The American Academy of Pediatrics recommends amoxicillin as the first-line antibiotic for treating community-acquired pneumonia in children, including previously healthy, appropriately immunized infants, preschool children, school-aged children, and adolescents with mild to moderate bacterial pneumonia 1, 2, 3, 4
Amoxicillin is the first choice for oral antibiotic therapy in infants and preschool children because it is effective against the majority of pathogens causing community-acquired pneumonia in this age group, particularly Streptococcus pneumoniae, is well tolerated, and inexpensive 5
The Infectious Diseases Society of America recommends a dose of 90 mg/kg/day divided into 2 doses for outpatient management of community-acquired pneumonia in infants and preschool children 6

The American Academy of Pediatrics suggests that antimicrobial therapy is not routinely required for preschool-aged children with community-acquired pneumonia because viral pathogens are responsible for the great majority of clinical disease 1, 2, 3, 4
Young children presenting with mild symptoms of lower respiratory tract infection need not be treated with antibiotics, according to the British Thoracic Society 5

Oral amoxicillin is safe and effective for children presenting with community-acquired pneumonia, as stated by the British Thoracic Society 5
Intravenous antibiotics should be used when the child is unable to absorb oral antibiotics or presents with severe signs and symptoms, according to the British Thoracic Society 5

The Infectious Diseases Society of America recommends ampicillin or penicillin G for fully immunized infants or school-aged children admitted to a hospital ward when local epidemiology documents lack of substantial high-level penicillin resistance 1, 2, 3, 4
Third-generation parenteral cephalosporins, such as ceftriaxone or cefotaxime, should be prescribed for hospitalized infants and children who are not fully immunized, in regions with high-level penicillin resistance, or for life-threatening infections, including empyema, as recommended by the Infectious Diseases Society of America 1, 2, 4

Alternative agents, including co-amoxiclav, cefaclor, erythromycin, clarithromycin, and azithromycin, can be used for patients with penicillin allergy, according to the British Thoracic Society 5
Macrolide antibiotics should be prescribed for children with findings compatible with atypical pathogens, as recommended by the Infectious Diseases Society of America 1, 2, 3, 4

Children cared for at home should be reviewed if deteriorating or if not improving after 48 hours on treatment, according to the British Thoracic Society 5