Which antibiotics is advisable for mild PNEUMONIA?

Resolved question:
Hi Doctor,

We live in a remote part of Sumatra Indonesia and our 21 month year old son has Pneumonia. We have been to 3 different doctors who have prescribed 3 different antibiotics so we are wondering what the most advisable antibiotic would be for him or if he should have a combination.

The antibiotics he has been given are:

1.Erythromycin (which he took last night and today and he seemed to get a little better)
2.Azithromycin (which the paediatrician prescribed him today and told us to take exclusively)
3.Cetrizine (which was prescribed two days ago and he had stpped taking)

We spoke to our family doctor in Australia and he said to take either one of the first two with the number 3 to get a broad spectrum and to cover type a antibiotics. However the paediatrician today told us to take number 2 exclusively so we are a little confused and as medical help out here is limited we want to make sure we are giving him the right option for his recovery.

I have also attached his xray which you may see where he has what the doctors are calling mild pneumonia.

P,S He is 12kgs, we can't get intouch with our GP right now

Forever greatful,

Dean & Jodie

Submitted: 4 Days
Category: Pediatrician

Expert:  Dr. Saptharishi L G replied 4 Days.

Hello. Thank you for posting your query at DoctorSpring.com
Dear Dean and Jodie,
I can understand your situation. Firstly, am not really sure if your son has pneumonia. The chest radiograph is grossly normal. Not all fever, cough and rapid breathing are bacterial pneumonia. Such symptoms can also be seen in viral pneumonia (that do not respond to antibacterial drugs).
Having said that, let us assume that your child actually has bacterial pneumonia. The choice of antibiotics would depend upon the organism or infectious agent that we are trying to target. Then, giving him erythromycin or azithromycin would not be wise according to me. These two would largely cover for chlamydia and mycoplasma. Giving amoxicillin-clavulunic acid to him would be the best option. Your child being 12 kg, you can give him 40 mg/kg/day i.e. 480 mg per day in two divided doses for 5 days. There is absolutely no rationale in combining erythromycin and azithromycin. If you wanna give only one of the three listed, then you can use Azithromycin.
Giving cetirizine would not be of much use. Kindly get back to me in case you have any other clarifications.
Regards

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