тогда необходим посев мокроты на определение микрофлоры и чувствительность к антибиотикам; амоксициллин или амоксиклав - препарат выбора, в штатах против назначения цефалоспоринов детям как препарату первой линии, но если высеется микрофлора, что чувствительна только к ним, тогда АБ назначаются согласно чувствительности
Community-acquired pneumonia (CAP) accounts for a significant percentage of antibiotic use in children. Unnecessary use of broad-spectrum antibiotics, including cephalosporins such as ceftriaxone, have been shown to contribute to antibiotic resistance and C. difficile infection. The most common cause of CAP in healthy, immunized children is Streptococcus pneumoniae, of which most strains are highly susceptible to penicillin/ampicillin. As ampicillin achieves high levels in the lung and is narrow in spectrum, it should be used as a first-line drug for inpatient management of most children with uncomplicated pediatric CAP. In cases with more resistant local epidemiology, or complicated CAP including empyema, antibiotics with a broader spectrum may be needed.
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American Academy of Pediatrics – Committee on Infectious Diseases and the Pediatric Infectious Diseases Society
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