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pediatric community-acquired and nosocomial pneumonia

Objectives: Pediatric Pneumonia With a focus on Community-Acquired Pneumonia. Discuss the different etiologies for both community and nosocomial pneumoniaList the common pathogens that are associated with both CAP and nosocomial pediatric pneumonia Demonstrate the different pathogens seen in different age groups for both community and nosocomial pneumonia. Discuss the prevalence of community acquired pneumonia (CAP) in the pediatric population.Discuss outpatient treatment considerations and 23

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pediatric community-acquired and nosocomial pneumonia

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    1. Pediatric Community-Acquired and Nosocomial Pneumonia

    3. DefinitionCommunity acquired pneumonia An acute infection of lung parenchyma including alveolar spaces and interstitial tissue. Pathogens gain access to the lungs by three routes. Inhaled aerosolized particles via the bloodstream aspiration The presence of fever, acute respiratory symptoms, plus the evidence of parenchymal infiltrates on chest x-ray.

    4. PrevalenceCommunity acquired pneumonia Pneumonia is the leading cause of death in children throughout the world. 4 million children a year die from pneumonia worldwide. In children < 5 the incidence is 34 to 40 cases per 1000 in Europe and North America. The incidence is higher in childhood than at any other time of life.

    5. PrevalenceCommunity acquired pneumonia

    6. Pediatr Infect Dis J 2002 21: 592-598 PathogensCommunity acquired pneumonia

    7. Etiology of Pediatric PneumoniaBirth to 3 Weeks

    8. Etiology of Pediatric Pneumonia3 Weeks to 3 Months

    9. Etiology of Pediatric Pneumonia3 Months to 5 Years

    10. Etiology of Pediatric Pneumonia5 to 15 Years

    11. N Engl J Med 2002 346: 429-437 Age-Specific PathogensCommunity acquired pneumonia

    12. Treatment ConsiderationsCommunity acquired pneumonia Allergies Age Resistance patterns Empiric therapy Compliance Duration of therapy

    13. N Engl J Med 2002 346: 429-437 Outpatient Management Community acquired pneumonia

    14. Azithromycin(Zithromax®) Class Macrolide Dosing 10 mg/kg x1 then 5 mg/kg QD for 4days Adverse Events nausea/vomiting diarrhea abdominal pain Rash Contraindications Hypersensitivity to macrolides (erythromycin, clarithromycin) Dosage forms Injection ? 500mg Suspension ? 100 mg/5 mL, 200 mg/5 mL Tablet ? 250 mg Compliance Tastes bad

    15. Amoxicillin(Amoxil®) Class Penicillin Dosing 80-100 mg/kg/day TID Adverse Events Rash Diarrhea Nausea/vomiting Contraindications Hypersensitivity to penicillins Dosage Forms Capsule ? 250 mg Tablet?125 mg, 250 mg, Suspension ? 125 mg/5 mL 250 mg/5 mL Compliance Tastes excellent

    16. SummaryCommunity acquired pneumonia The incidence of pneumonia is higher in children than in adults. It is important to identify the age specific pathogens and treat empirically. It is important to consider compliance issues such as taste when treating a pediatric patient.

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