Pediatric CAP Flashcards
CAP - Risk Factors
recent history of URI
lower socioeconomic status
crowded living
asthma
cigarette smoke exposure
CAP - Pathophysiology
pathogens enter the lungs through either inhaled particles, bloodstream, or aspiration
CAP - Signs & Symptoms
fever
cough, expectorant
chest pain
tachypnea (infants > 70 bpm, children > 50 bpm)
wheezing, crackles
pulse oximetry < 90% on room air
altered mental status
CAP - Diagnosis
gold standard - X-ray (lobar or diffuse consolidation)
CAP - Indication for Hospitalization
moderate-to-severe CAP
significant respiratory distress (SpO2 < 90%)
all infants < 3 mo
infants < 6 mo with suspected bacterial CAP
concern for caretaker capabilities
underlying medical conditions
suspicion / documentation of MRSA
CAP - Most Common Bacterial Pathogens
S. pneumoniae
H. influenzae
S. aureus
Group A streptococcus
CAP - Most Common Viral Pathogens
influenza
RSV
PIV
adenovirus
rhinovirus
CAP - Most Common Pathogens from Birth to 20 Days
GBS
Gram-negative enteric bacteria
listeria monocytogenes
CAP - Most Common Pathogens from 3 Weeks to 3 Months
S. pneumoniae
RSV
CAP - Most Common Pathogens from 3 Months to 5 Years
S. pneumoniae
RSV
CAP - Most Common Pathogens from 5 Years to 15 Years
S. pneumoniae
M. pneumoniae
C. pneumoniae
CAP - Outpatient Treatment for Presumed Bacterial Pneumonia
amoxicillin 90 mg/kg/day, divided
CAP - Inpatient Treatment for Presumed Bacterial Pneumonia
if fully immunized: ampicillin or penicillin G plus vancomycin if suspected MRSA
if not fully immunized: ceftriaxone or cefotaxime plus vancomycin for suspected MRSA
CAP - Outpatient Treatment for Presumed Atypical Pneumonia
azithromycin 10 mg/kg on day 1, then 5 mg/kg/day on days 2-5
OR
clarithromycin 15 mg/kg/day, divided, for 7-14 days
CAP - Inpatient Treatment for Presumed Atypical Pneumonia
azithromycin plus beta-lactam
