How are pediatric pneumococcal infections treated in patients allergic to penicillin?

Updated: Jan 14, 2019
  • Author: Meera Varman, MD; Chief Editor: Russell W Steele, MD  more...
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Answer

Otitis media, sinusitis, outpatient treatment of pneumonia: Administer azithromycin (or other macrolide), clindamycin (if not allergic to cephalosporins), cefuroxime, or cefprozil.

Inpatient treatment of pneumonia or other invasive infections: Administer intravenous ceftriaxone if the patient is not allergic to cephalosporins. If the patient is allergic to cephalosporins, administer intravenous clindamycin or meropenem. Meropenem has 5-10% cross-reactivity with beta-lactams; therefore, hypersensitivity testing may need to be performed if the allergy is severe. Consider adding vancomycin if the patient is severely ill and organism susceptibility is not known.


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