Treatment

Very severe/ Severe pneumonia

Give oxygen 2-4 litres/min

Maintain the airways by gentle suction of any thick secretions.

Ampicillin IV 50mg/kg 6 hourly and Gentamicin IV 7.5mg/kg once a day for at least 5 days.

If the child does not improve within 48 hours, add Cloxacillin IV 50mg/kg 6 hourly to cover for staphylococcal pneumonia.

If the child does not improve within 48 hours and staphylococcal pneumonia is not suspected use Ceftriaxone IV 75mg/kg once daily for 10 days or consider evaluation of other diseases or complications.

If HIV exposed/infected add Co-trimoxazole IV or PO 8mg/kg of Trimethoprim and 40mg/kg of Sulfamethoxazole 8 hourly for 3weeks for Pneumocystis pneumonia (PCP)

If the child has fever (≥38.5°C), give Paracetamol PO 15 mg/kg

If the child has a wheeze, give nebulized salbutamol 2.5mg i.e. 0.5ml of the 5mg/ml nebulizer solution.

Pneumonia

Amoxicillin DT PO 40mg/kg 12 hourly for 5 days

For children above 5years, atypical pneumonia should be considered so give macrolide as a drug of choice:
o Erythromycin PO 12.5mg/kg 6 hourly for 5 days in pneumonia
o Azithromycin PO 10mg/kg once daily for 5 days in pneumonia

No pneumonia/Cough or cold

Supportive treatment is recommended.