Community-Acquired Pneumonia - Decision to Continue Parenteral Antibiotic Therapy for Child

Patient selection: pediatric patient with CAP

Reasons to consider switching the patient from parenteral to oral antibiotics:

(1) resolution of fever

(2) improvement in cough

(3) improvement in tachypnea

(4) no need for supplemental oxygen

(5) increased activity

(6) improved appetite

(7) reduction in the white blood cell count

(8) reduction in serum CRP

(9) antibiotic available with good oral absorption

(10) compliant family

Reasons to consider continued parenteral therapy:

(1) require high antibiotic concentrations not achievable with oral therapy

(2) no acceptable oral formulation

(3) unable to tolerate oral antibiotic

(4) deterioration on oral therapy

A patient who still needs a parenteral antibiotic can be discharged once stable and treated as an outpatient using a PICC line, port infusion or intramuscular injection.