Management of Pediatric Pneumonia

Treatment Recommendations

The American Academy of Pediatrics recommends amoxicilina oral at 90 mg/kg/day divided into 2-3 doses for 5 days as the first-line treatment for children under 5 years old with community-acquired pneumonia 2, 3, 4
For children over 5 years old, macrolides (azithromycin, clarithromycin) are recommended as first-line treatment due to the higher prevalence of Mycoplasma pneumoniae 2, 3

The American College of Chest Physicians recommends ipratropium bromide for bronchospasm in asthma, as it provides additional benefit when combined with beta-agonists in acute asthma exacerbations 1
The American Academy of Allergy, Asthma, and Immunology recommends ipratropium bromide for rhinorrhea in allergic rhinitis and common cold 5

The American Academy of Pediatrics recommends oxygen supplementation to maintain saturation >92% 2, 3
The American Academy of Pediatrics recommends antipyretics and analgésics (acetaminophen, ibuprofen) for fever and comfort 2, 3
The American Academy of Pediatrics recommends adequate hydration with IV fluids at 80% of baseline levels if necessary 2
The American Academy of Pediatrics recommends elevating the head of the bed 30-45 degrees to improve breathing 2
The American Academy of Pediatrics recommends gentle nasal suction as needed 2

The Journal of Allergy and Clinical Immunology advises against prescribing ipratropium for pneumonia, as it is a conceptual error that confuses bronchospasm with pulmonary consolidation 1
The American Academy of Pediatrics advises against using chest physiotherapy, as it is not beneficial and should not be performed in children with pneumonia 2, 3

The American College of Chest Physicians recommends considering ipratropium bromide if the child has coexisting asthma with acute exacerbation in addition to pneumonia 1