Monitoring
Predictors of treatment response are decrease in respiratory signs and defervescence within 48-72 hours of antimicrobial therapy. A switch to oral therapy may be considered once there is improvement in fever, cough, tachypnea, supplemental oxygen dependency, and increased activity and appetite, concurrent with a decrease in WBC counts and/or CRP levels. Children who developed lobar collapse, round pneumonia, or radiographic findings of community-acquired pneumonia complications may have an outpatient follow-up at 6-8 weeks with clinical evaluation and chest X-ray.
Specialist Referral
Consultation with a pediatric pulmonologist or infectious diseases specialist is considered if the patient has allergies, other coexisting illnesses, or the presence of complications (eg effusion, empyema, bronchiectasis, hemolytic uremic syndrome, necrotizing pneumonia, or sepsis); shows no clinical improvement despite receiving antibiotic therapy; and has recurrent pneumonia.