Persistent pneumonia

In patients not responding to therapy, consider atypical pneumonia, tuberculosis, pneumocystosis (HIV infection and AIDS, Chapter 8).

Bacteria responsible for atypical pneumonia are mainly Mycoplasma pneumoniae and Chlamydophila pneumoniae. If suspected, one of the following antibiotics may be used:

First choice, azithromycin PO
Children: 10 mg/kg once daily (max. 500 mg daily) for 5 days
Adults: 500 mg on D1 then, 250 mg once daily from D2 to D5

If not available,
erythromycin PO
Children: 10 mg/kg 4 times daily for 10 to 14 days
Adults: 500 mg 4 times daily for 10 to 14 days
or
doxycycline PO (except in children under 8 years and pregnant or lactating women)
Children: 2 mg/kg 2 times daily (max. 200 mg daily) for 10 to 14 days
Adults: 100 mg 2 times daily for 10 to 14 days