Respiratory

Oral therapy is safe and effective in mild CAP.  Intravenous amoxicillin or clarithromycin therapy is only indicated in those who cannot tolerate oral medication.

Amoxicillin oral*

If true penicillin allergy:

Clarithromycin oral

*Note: consider adding clarithromycin if mycoplasma pneumonia suspected

Co-amoxiclav IV

Duration: Uncomplicated pneumonia; 7 days

For advice regarding antivirals in influenza, refer to HPS guidance:

On admission or up to 48h after admission

Treatment

Co-amoxiclav IV

If true penicillin allergy:

Cefotaxime IV

Plus

Metronidazole IV

Over 48h after admission

Review risk of MRSA infection and available microbiology/virology results and seek advice

Treatment

Cefotaxime IV

Plus

Metronidazole IV

Review most recent culture and sensitivity results as this may guide treatment choice.

Co-amoxiclav PO or IV

If true penicillin allergy:

Seek Microbiology advice

Duration: 10 to 14 days

Refer to Scottish Paediatric CF MCN prescribing guidelines.

Clarithromycin oral or IV

Treat for 7 days

If clinically suspected take NPA in children under 2 years old or a throat swab in older children (both in viral transport medium for PCR).

This is a reportable disease and during working hours contact Public Health Medicine who will review the need for prophylaxis in contacts.

Aciclovir IV (high dose)

Treat for minimum 7 days

Patients should be adequately hydrated during high dose aciclovir therapy. Ensure urine output is at least 1 ml/kg/hr.

Co-trimoxazole IV (high dose)

Seek specialist advice

Treat for minimum 14 days. If immunocompromised, treat for 21 days.