Pneumonia, Nosocomial
Description General and supportive measures Medicine treatment ICD-10 code: J18.9 DESCRIPTION Children acquiring pneumonia 48–72 hours after hospitalisation. The common pathogens are: ß-lactamase producing pathogens, Extended spectrum ß-lactamase producing Klebsiella pneumoniae , P. aeruginosa , Multidrug resistant Acinetobacter species, Methicillin resistant S. aureus , Respiratory
Description
General and supportive measures
Medicine treatment
ICD-10 code: J18.9
DESCRIPTION
Children acquiring pneumonia 48–72 hours after hospitalisation.
The common pathogens are:
- ß-lactamase producing pathogens,
- Extended spectrum ß-lactamase producing Klebsiella pneumoniae, P. aeruginosa,
- Multidrug resistant Acinetobacter species,
- Methicillin resistant S. aureus,
- Respiratory viruses, i.e. respiratory syncytial virus, adenovirus, influenza, herpes, parainfluenza.
GENERAL AND SUPPORTIVE MEASURES
- Sepsis screen including blood cultures.
MEDICINE TREATMENT
Empirical antibiotic therapy
- Broad spectrum antibiotics should be administered according to local susceptibility patterns and underlying predisposing factors.
- Review antibiotic choice once culture and sensitivity results become available.
For bacterial infections:
Empiric therapy in the absence of local data:
- Piperacillin/tazobactam, IV, 100 mg/kg/dose 8 hourly.
PLUS
- Amikacin, IV, 15 mg/kg/dose, daily.
Adjust therapy according to sensitivities.
Reconsider empirical antibiotic therapy and duration of therapy daily.
For methicillin resistant S. aureus pneumonia:
- Vancomycin, IV, 15 mg/kg/dose 6 hourly infused over 1 hour.
Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Paediatrics, 2023 Edition
Chapter 15: Respiratory System, 15.1 Cough With Predominant Fever And Tachypnoea ,15.1.1 Pneumonia, 15.1.1.4 Pneumonia, Nosocomial