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South Australian Paediatric Clinical Practice Guidelines 

Pneumonia  
 Community Acquired Pneumonia in Children 

  Department for Health and Wellbeing, Government of South Australia. All rights reserved. 

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Public I4-A4 
 

 
 
Note:
This guideline provides advice of a general nature.  This statewide guideline has been prepared to promote and 
facilitate standardisation and consistency of practice, using a multidisciplinary approach.  The guideline is based 
on a review of published evidence and expert opinion.  
Information in this statewide guideline is current at the time of publication.  
SA Health does not accept responsibility for the quality or accuracy of material on websites linked from this site 
and does not sponsor, approve or endorse materials on such links. 
Health practitioners in the South Australian public health sector are expected to review specific details of each 
patient and professionally assess the applicability of the relevant guideline to that clinical situation. 
If for good clinical reasons, a decision is made to depart from the guideline, the responsible clinician must 
document in the patient s medical record, the decision made, by whom, and detailed reasons for the departure 
from the guideline. 
This statewide guideline does not address all the elements of clinical practice and assumes that the individual 
clinicians are responsible for discussing care with consumers in an environment that is culturally appropriate and 
which enables respectful confidential discussion. This includes: 

  The use of interpreter services where necessary, 
  Advising consumers of their choice and ensuring informed consent is obtained, 
  Providing care within scope of practice, meeting all legislative requirements and maintaining 

standards of professional conduct, and  
  Documenting all care in accordance with mandatory and local requirements 

 

Explanation of the aboriginal artwork: 
The aboriginal artwork used symbolises the connection to country and the circle shape shows the strong relationships amongst families and the aboriginal culture. 
The horse shoe shape design shown in front of the generic statement symbolises a woman and those enclosing a smaller horse shoe shape depicts a pregnant 
woman. The smaller horse shoe shape in this instance represents the unborn child. The artwork shown before the specific statements within the document 
symbolises a footprint and demonstrates the need to move forward together in unison. 
 

     

 

 

 

 

 

 
 
 
 
The term  Aboriginal  is used to refer to people who identify as Aboriginal, Torres Strait Islanders, or both Aboriginal and Torres Strait 
Islander.  This is done because the people indigenous to South Australia are Aboriginal and we respect that many Aboriginal people prefer 
the term  Aboriginal .  We also acknowledge and respect that many Aboriginal South Australians prefer to be known by their specific 
language group(s). 

 Cultural safety enhances clinical safety.  

To secure the best health outcomes, clinicians must provide a culturally safe health 
care experience for Aboriginal children, young people and their families. Aboriginal 
children are born into strong kinship structures where roles and responsibilities are 
integral and woven into the social fabric of Aboriginal societies. 

Australian Aboriginal culture is the oldest living culture in the world, yet Aboriginal 
people currently experience the poorest health outcomes when compared to non-
Aboriginal Australians. 
 
It remains a national disgrace that Australia has one of the highest youth suicide 
rates in the world.  The over representation of Aboriginal children and young people 
in out of home care and juvenile detention and justice system is intolerable. 
 
The accumulated effects of forced removal of Aboriginal children, poverty, exposure 
to violence, historical and transgenerational trauma, the ongoing effects of past and 
present systemic racism, culturally unsafe and discriminatory health services are all 
major contributors to the disparities in Aboriginal health outcomes. 

 
Clinicians can secure positive long term health and wellbeing outcomes by making 
well informed clinical decisions based on cultural considerations. 

 

 

 

     



Pneumonia  
 (Community Acquired Pneumonia in Children) 
 

 

 
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Purpose and Scope of PCPG 

Community Acquired Pneumonia (CAP) is an acute infection of the pulmonary parenchyma 
acquired outside of a hospital setting and is one of the most common serious infections in 
children. Streptococcus pneumoniae is the most common cause of bacterial CAP in children 
under five years of age, whereas Mycoplasma is the leading cause of CAP in children 
greater than five years of age 

The Management of CAP is primarily aimed at medical staff working in any of primary care, 
local, regional, general or tertiary hospitals. It may however assist the care provided by 
other clinicians such as nurses. The information is current at the time of publication and 
provides a minimum standard for the assessment (including investigations) and 
management of pneumonia; it does not replace or remove clinical judgement or the 
professional care and duty necessary for each specific case. 

Definitions and Abbreviations 

CRP C-reactive protein 

MRSA Methicillin-resistant Staphylococcus aureus (MRSA) are resistant to 
methicillin (a derivative of penicillin) and other closely related antibiotics 
(oxacillin, flucloxacillin). They may also be resistant to a number of other 
antibiotics (sometimes referred to as multi-resistant strains). 

PCR Polymerase Chain Reaction 

 

Table of Contents 
 
Purpose and Scope of PCPG .................................................................................................. 2 

Definitions and Abbreviations .................................................................................................. 2 

Table of Contents .................................................................................................................... 2 

Introduction .............................................................................................................................. 3 

Procedure ................................................................................................................................ 3 

Community-acquired pneumonia in children ........................................................................... 3 

References ............................................................................................................................... 4 

Acknowledgements .................................................................................................................. 5 

Document Ownership &amp; History ............................................................................................... 5 

 

  



Pneumonia  
 (Community Acquired Pneumonia in Children) 
 

 

 
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Introduction 
Information contained in the SA Health Pneumonia (Community Acquired Pneumonia in 
Children) is adapted from empirical antibiotic therapy of community-acquired pneumonia in 
children, published on  eTG complete  by Therapeutic Guidelines (www.tg.org.au) on April 
2019 (eTG March 2020 edition).  

Procedure  
This procedure is aimed for use with a child with simple community acquired pneumonia.  

This procedure should not be used for patients with severe or complex illness, aspiration 
pneumonia, or hospital acquired pneumonia, or those with underlying cystic fibrosis, chronic 
lung pathology, or immunocompromised. These patients should be urgently discussed with 
the Paediatric Consultant on-call.  

Community-acquired pneumonia in children 
The following community-acquired pneumonia (CAP) in children guidelines, produced by 
Therapeutic Guidelines Limited, include clear instructions for therapy and assist medical 
officers in making decisions to ensure patients receive optimum treatment. 

NB. South Australia has developed a specific guideline for neonatal sepsis presenting from 
the community and this should be preferentially used for this age group. See Paediatric 
Practice Guideline: Neonatal Sepsis Presenting from the Community available at: 
https://extapps2.sahealth.sa.gov.au/PracticeGuidelines/.  

With respect to investigations of community acquired pneumonia in any age group in South 
Australia we recommend: 

  Respiratory pathogen PCR screen (nasal/pharyngeal swab) 
  Sterile site PCR from blood 
  Blood culture 
  White cell count/differential/CRP. 

&gt; CAP in neonates and children younger than 2 months1 
https://tgldcdp.tg.org.au/viewTopic?topicfile=community-acquired-pneumonia-
children#toc_d1e47.  

&gt; CAP in children 2 months or older: aetiology and management approach2 
https://tgldcdp.tg.org.au/viewTopic?topicfile=community-acquired-pneumonia-
children#toc_d1e328. 

&gt; CAP in children 2 months or older: empirical therapy for low-severity CAP3 
https://tgldcdp.tg.org.au/viewTopic?topicfile=community-acquired-pneumonia-
children#toc_d1e468. 

&gt; CAP in children 2 months or older: empirical therapy for moderate-severity CAP4 
https://tgldcdp.tg.org.au/viewTopic?topicfile=community-acquired-pneumonia-
children#toc_d1e593. 

&gt; CAP in children 2 months or older: empirical therapy for high-severity CAP5 
https://tgldcdp.tg.org.au/viewTopic?topicfile=community-acquired-pneumonia-
children#toc_d1e966.  

NB. In South Australia for empiric cover of MRSA we recommend intravenous vancomycin 
as first line.  















Pneumonia  
 (Community Acquired Pneumonia in Children) 
 

 

 
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References 

1. eTG complete Melbourne: Therapeutic Guidelines Limited 2019. Community-acquired 
pneumonia in neonates and children younger than 2 months. [ONLINE] Available at:  
https://tgldcdp.tg.org.au/viewTopic?topicfile=community-acquired-pneumonia-
children#toc_d1e47, Accessed 9 July 2019. 

2. eTG complete Melbourne: Therapeutic Guidelines Limited 2019. Community-acquired 
pneumonia in children 2 months or older: aetiology and management approach. 
[ONLINE] Available at:  https://tgldcdp.tg.org.au/viewTopic?topicfile=community-
acquired-pneumonia-children#toc_d1e328, Accessed 9 July 2019.  

3. eTG complete Melbourne: Therapeutic Guidelines Limited 2019. Community-acquired 
pneumonia in children 2 months or older: empirical therapy for low-severity CAP. 
[ONLINE] Available at:   https://tgldcdp.tg.org.au/viewTopic?topicfile=community-
acquired-pneumonia-children#toc_d1e468, Accessed 9 July 2019.   

4. eTG complete Melbourne: Therapeutic Guidelines Limited 2019. Community-acquired 
pneumonia in children 2 months or older: empirical therapy for moderate-severity CAP. 
[ONLINE] Available at: https://tgldcdp.tg.org.au/viewTopic?topicfile=community-
acquired-pneumonia-children#toc_d1e593, Accessed 9 July 2019.    

5. eTG complete Melbourne: Therapeutic Guidelines Limited 2019. Community-acquired 
pneumonia in children 2 months or older: empirical therapy for high-severity CAP. 
[ONLINE] Available at: https://tgldcdp.tg.org.au/viewTopic?topicfile=community-
acquired-pneumonia-children#toc_d1e966, Accessed 9 July 2019.  

6. eTG complete Melbourne: Therapeutic Guidelines Limited 2019. Key references: 
Community-acquired pneumonia in children guidelines. [ONLINE] Available at: 
https://tgldcdp.tg.org.au/viewTopic?topicfile=community-acquired-pneumonia-
children#MPS_d1e1727, Accessed 9 July 2019. 

  















Pneumonia  
 (Community Acquired Pneumonia in Children) 
 

 

 
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Acknowledgements 
The South Australian Child and Adolescent Health Community of Practice gratefully 
acknowledge the contribution of clinicians and other stakeholders who participated 
throughout the guideline development process particularly the:  

 
SA Paediatric Clinical Practice Guidelines Reference Group  

Document Ownership &amp; History 
Developed by: SA Child &amp; Adolescent Health Community of Practice 
Contact: Health.PaediatricClinicalGuidelines@sa.gov.au 

Endorsed by:  Commissioning and Performance, SA Health 

Next review due:  01/07/2025  
ISBN number:  978-1-74243-909-9 
PDS reference:  CG335   
Policy history: Is this a new policy (V1)?  Y 
 Does this policy amend or update and existing policy?    N 
 If so, which version? 
 Does this policy replace another policy with a different title?  N 
 If so, which policy (title)? 
 
 

Approval 
Date Version 

Who approved New/Revised 
Version Reason for Change 

01/07/20 V1 
Lynne Cowan, Deputy CE, 
Commissioning and Performance, SA 
Department for Health and Wellbeing 

Original Commissioning and 
Performance approved version 

 



	Purpose and Scope of PCPG
	Definitions and Abbreviations
	Table of Contents
	Introduction
	Procedure
	Community-acquired pneumonia in children
	References
	Acknowledgements
	Document Ownership &amp; History

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