Pcap Management
Approach Considerations
Treatment decisions in children with pneumonia are dictated based on the likely etiology of the infectious organism and the age and clinical status of the patient. Antibiotic administration must be targeted to the likely organism, bearing in mind the age of the patient, the history of exposure, the possibility of resistance (which may vary, depending on local resistance patterns), and other pertinent history (see Etiology and Clinical Presentation).
After initiating therapy, the most important tasks are resolving the symptoms and clearing the infiltrate. With successful therapy, symptoms resolve much sooner that the infiltrate. In a study of adults with pneumococcal pneumonia, the infiltrate did not completely resolve in all patients until 8 weeks after therapy (although it was sooner in most patients). If therapy fails to elicit a response, the whole treatment approach must be reconsidered.
The Pediatric Infectious Diseases Society and the Infectious Diseases Society of America created evidence-based guidelines for the management of community-acquired pneumonia (CAP) in infants and children older than 3 months. These guidelines discuss site-of-care management, diagnosis, antimicrobial therapy, adjunctive surgical therapy, and prevention. While these guidelines do not represent the only approach to diagnosis and therapy, these recommendations may assist in decreasing morbidity and mortality rates in children with CAP.[43]
Hospitalization
Pulse oximetry should be performed during the prehospital evaluation of children with suspected pneumonia, and supplemental oxygen should be administered, if necessary; however, many school-aged children do not require hospitalization and respond well to oral antibiotics. Usually, these patients are not toxic or hypoxic enough to require supplemental oxygen. Unless they are vomiting, they do not require intravenous fluids or antibiotics. A parapneumonic effusion that requires drainage usually dictates
Treatment decisions in children with pneumonia are dictated based on the likely etiology of the infectious organism and the age and clinical status of the patient. Antibiotic administration must be targeted to the likely organism, bearing in mind the age of the patient, the history of exposure, the possibility of resistance (which may vary, depending on local resistance patterns), and other pertinent history (see Etiology and Clinical Presentation).
After initiating therapy, the most important tasks are resolving the symptoms and clearing the infiltrate. With successful therapy, symptoms resolve much sooner that the infiltrate. In a study of adults with pneumococcal pneumonia, the infiltrate did not completely resolve in all patients until 8 weeks after therapy (although it was sooner in most patients). If therapy fails to elicit a response, the whole treatment approach must be reconsidered.
The Pediatric Infectious Diseases Society and the Infectious Diseases Society of America created evidence-based guidelines for the management of community-acquired pneumonia (CAP) in infants and children older than 3 months. These guidelines discuss site-of-care management, diagnosis, antimicrobial therapy, adjunctive surgical therapy, and prevention. While these guidelines do not represent the only approach to diagnosis and therapy, these recommendations may assist in decreasing morbidity and mortality rates in children with CAP.[43]
Hospitalization
Pulse oximetry should be performed during the prehospital evaluation of children with suspected pneumonia, and supplemental oxygen should be administered, if necessary; however, many school-aged children do not require hospitalization and respond well to oral antibiotics. Usually, these patients are not toxic or hypoxic enough to require supplemental oxygen. Unless they are vomiting, they do not require intravenous fluids or antibiotics. A parapneumonic effusion that requires drainage usually dictates