If there are no signs of recovery; especially if the patient remains toxic and ill with
spiking temperature for 48-72 hours, a 2nd of 3
rd line antibiotic therapy need to be
considered. If Mycoplasma or Chlamydia species are the causative agents, a macrolide
is the appropriate choice
A child admitted to hospital with severe community acquired pneumonia must receive
parenteral antibiotics. As a rule, in severe cases of pneumonia, combination therapy
using a second or third generation cephalasporins and macrolide should be given.
Staphylococcal infections and infection caused by Gram negative organisms such as
Klebsiella sp are more frequently reported in malnourished children.