35.4.4 Treatment of pneumonia
Infants less than two months old with pneumonia may have serious complications such as meningitis and may die soon. Refer them urgently!
Severe pneumonia in children and adults is diagnosed if they exhibit the signs summarised in Box 35.4. You should refer all patients with severe pneumonia immediately to the nearest health centre or hospital, where appropriate drugs can be prescribed by doctors or health officers.
For adults with non-severe pneumonia, give amoxicillin tablets, 500 mg three times a day for seven days. Details of the treatment of severe and non-severe pneumonia in children are given in a separate Module on the Integrated Management of Newborn and Childhood Illness (IMNCI). Here we remind you of the oral antibiotics you can give children with non-severe pneumonia without any other danger signs. The course of treatment is for five days with either co-trimoxazole (the preferred antibiotic drug), or if co-trimoxazole is not available, give amoxicillin. The doses of co-trimoxazole or amoxicillin depend on the age or weight of the child, and were summarised earlier in Table 35.1. Look back at it now, and then answer the following question.
Suppose you saw a three-year-old girl with non-severe pneumonia. What dose of co-trimoxazole syrup would you give this child, and for how many days?
She is between 12 months and five years, so you should give her 7.5ml (one and a half teaspoons) of co-trimoxazole syrup (containing 80 mg trimethoprim + 400 mg sulphamethoxazole), twice a day for five days (look back at Table 35.1).
If any of your non-severe patients do not improve with the drug treatments you give them, or if their condition gets worse, immediately refer them to the nearest health centre or hospital.
Co-trimoxazole for HIV-positive children should be prescribed by doctors as prophylaxis against opportunistic infections with bacteria, viruses and fungi that cause pneumonia. Part 3 of this Module includes a detailed discussion of the prevention and treatment of pneumonia in people living with HIV infection.
If a one-month-old child comes to you with symptoms of fever and a respiration rate of 70 breaths per minute, what should you do?
The child is less than two months old and may have pneumonia, so it is at high risk of serious complications (e.g. meningitis and death). Therefore, refer the baby immediately to the nearest hospital or health centre.
35.4.3 Diagnosis and classification of pneumonia