Pedemy All toolsAnswer one question at a time. Doses are calculated for the weight entered. Tap any earlier answer to change it.
This tool helps clinicians manage community-acquired pneumonia in children: deciding between outpatient care and admission, and choosing an antibiotic based on age, immunization status and penicillin allergy. Entering a weight gives doses in milligrams.
Infants under 3 months are directed to admission and treatment as possible sepsis. For older children, the tool checks reasons to admit, such as SpO2 under 90% on room air, moderate to severe respiratory distress, toxic appearance or inability to take oral medicine, age 3–6 months with suspected bacterial pneumonia, complicated pneumonia, or failed outpatient treatment. For admitted children it asks whether they are fully immunized against Hib and pneumococcus, then asks about penicillin allergy (none, low-risk or high-risk history).
Outpatients get high-dose amoxicillin 90 mg/kg/day in 2 doses for 5 days, or cefdinir or levofloxacin depending on allergy, with azithromycin added from school age if atypical infection is likely. Fully immunized inpatients get IV ampicillin; others get ceftriaxone, with vancomycin or clindamycin for MRSA risk. It is based on the 2011 PIDS/IDSA guideline (Bradley et al.) and the 2022 SCOUT-CAP trial.
For outpatient community-acquired pneumonia, the tool gives high-dose amoxicillin 90 mg/kg/day divided into 2 doses (max 4 g/day) for 5 days.
Reasons listed include SpO2 under 90% on room air, grunting, retractions, apnea or RR over 70 (infant) or 50 (child), toxic appearance, sepsis or dehydration, inability to take oral medicine, age 3–6 months with suspected bacterial pneumonia, complicated pneumonia, failed outpatient treatment, or concern about follow-up. All infants under 3 months are admitted.
Fully immunized children without penicillin allergy can receive narrow-spectrum IV ampicillin 150–200 mg/kg/day in 4 doses. Children not fully immunized receive ceftriaxone. Vancomycin is added for MRSA risk, such as necrotizing pneumonia or empyema.
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