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Staphylococcal pneumonia

Staphylococcal pneumonia is suspected if there is rapid clinical deterioration despite treatment, a pneumatocoele or necrotising pneumonia with effusion on chest X-ray, numerous Gram-positive cocci in a smear of sputum, or heavy growth of Staphylococcus aureus in cultured sputum or empyema fluid.

O Treat with cloxacillin (50 mg/kg IM or IV every 6 hours) and gentamicin (7.5 mg/kg IM or IV once a day) for at least 7 days.

O When the child improves, continue cloxacillin/flucloxacil- lin orally four times a day for a total course of 3 weeks. Note that cloxacillin can be substituted by another anti- staphylococcal antibiotic, such as oxacillin, flucloxacillin or dicloxacillin.