Treatment of Aspiration Pneumonia in Children

Assessment of Severity

The American Thoracic Society recommends hospital admission for children with oxygen saturation <92% or cyanosis, respiratory rate >50 breaths/min, difficulty breathing or grunting, signs of dehydration, or if the family is unable to provide appropriate observation 2

The Infectious Diseases Society of America recommends oral amoxicillin at 90 mg/kg/day in 2 doses as the first-line treatment for outpatient management of aspiration pneumonia in children, with a duration of 7-14 days 1
For severe cases requiring hospitalization, the Infectious Diseases Society of America recommends intravenous antibiotics, including ampicillin or penicillin G, ceftriaxone or cefotaxime, and consideration of adding vancomycin or clindamycin if MRSA is suspected 1

The American Thoracic Society recommends providing supplemental oxygen if saturation is ≤92% and maintaining oxygen saturation >92% using nasal cannulae, head box, or face mask 3
The American Academy of Pediatrics recommends ensuring adequate hydration, monitoring serum electrolytes in severely ill children, and avoiding nasogastric tubes if possible 3

The American Academy of Pediatrics recommends reviewing the child within 48 hours if not improving on treatment and re-evaluating for possible complications if the child remains pyrexial or unwell after 48 hours of appropriate treatment 2