Test Your Knowledge of Managing Pediatric Community-Acquired Pneumonia in Urgent Care (Postscript 2 of 2)

Evidence-Based Urgent Care Postscript
Pediatric Community-Acquired Pneumonia: Diagnosis and Management in the Urgent Care Setting | January 2024

A 5-year-old vaccinated boy presents to the urgent care clinic with ill appearance, persistent fever, dehydration, and worsened work of breathing at home, after a diagnosis of CAP by his pediatrician and 2 days of amoxicillin therapy. On examination, you hear decreased breath sounds over the right lower lung field. A chest x-ray shows opacification on the right, with concern for pleural fluid. Which of the following is the best next step?

  1. Consider ordering laboratory studies and drawing a blood culture to assess for complications associated with CAP.
  2. Change the antibiotics to azithromycin to cover for atypical pneumonia.
  3. Tell the family to stop the amoxicillin as the most likely etiology of the pneumonia is viral and antibiotics are not helping.
  4. Transfer to a higher level of care for further evaluation and management of complicated CAP.

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