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16.2.6

Pneumonia in Children

Malawi Standard Treatment Guidelines, 6th Edition, 2023. Chapter 16, Respiratory Conditions.

Clinical Description

WHO Classification of pneumonia

No Pneumonia: cough and cold

Pneumonia: fast breathing and/or chest indrawing

Severe Pneumonia: Pneumonia plus General danger sign (not able to drink, persistent vomiting, convulsions, lethargic or unconscious, stridor in a calm child or severe malnutrition)

Signs and Symptoms

  • Cough
  • Fever
  • Tachypnoea
  • Signs of respiratory distress
  • Bronchial breathing, crackles

Treatment

  • No pneumonia: home care advice
  • Pneumonia: Oral amoxicillin 15mg/kg 8 hourly for 5 days

HOME CARE ADVICE

Severe Pneumonia:

  • Assess and manage ABCCCD
  • Give Oxygen
  • Consider CPAP if severe respiratory distress
  • Benzyl Penicillin 50,000 IU IV 6 hourly and
  • Gentamicin 7.5mg IV 24 hourly
  • Change to oral antibiotics once tolerating orally
  • Antipyretics

Complications

  • Pleural effusion and Empyema
  • Investigate for TB
  • Continue IV antibiotics and insert chest drain
  • Refer patients with complicated empyema
  • Lung abscess
  • Refer for surgical drainage
  • Septicaemia

Refer all patients with complications

Check doses against the printed guideline and your clinical judgement before treating a patient. Spotted an error? Report it from the contact links below.

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