Community-acquired pneumonia

500-1000 mg TID x 5-7 days

80-90 mg/kg/day [child max 1000 mg]

(Divided BID-TID; targets penicillin-intermediate S. pneumoniae ENDF caps amoxicillin at 500 mg per dose for most indications; at the twice-daily schedule this regimen uses, that is 1,000 mg in a day, which is the ceiling applied to the table above (ENDF Antimicrobial 2023).)

Egyptian National Drug Formulary - Antimicrobial 2023

Narrower-spectrum beta-lactam used first-line for mild community-acquired pneumonia without comorbidities, targeting the typical bacterial pathogens responsible for most uncomplicated cases.

500 mg BID x 7 days

15 mg/kg/day [child max 1000 mg] (Divided BID for 7 days)

WATCH group - carries resistance cost. Egyptian EML 2025.

Egyptian National Drug Formulary - Antimicrobial 2023

Not used alone here. The 2019 ATS/IDSA guidance prefers high-dose amoxicillin as empiric therapy for healthy outpatients 64 and under, and allows a macrolide alone only where local S. pneumoniae macrolide resistance stays under 25%. The same guidance reports resistance often above 30% in the US and above 25% across most of the rest of the world, and no Egyptian figure appears in the cited sources, so that 25% condition cannot be shown to hold here. The Egyptian formulary uses the same cutoff and also defaults to combination therapy. Combine with a beta-lactam, or use levofloxacin instead.

750 mg once daily x 5-7 days

Contraindicated in children under 18 years (arthropathy risk)

WATCH group - carries resistance cost. Egyptian EML 2025.

ATS/IDSA CAP Guideline 2019

Respiratory fluoroquinolone with broad activity against both typical and atypical pneumonia pathogens; reserved for patients with comorbidities or those failing first-line beta-lactam therapy, rather than used as initial treatment.

100 mg twice daily x 5-7 days

2.2 mg/kg/dose [child max 100 mg]

(2.2 mg/kg per dose every 12 hours, maximum 100 mg per dose. The formulary restricts use under 8 years to severe or life- threatening infection, or where there is no better alternative - in practice that means a child with CAP gets amoxicillin, not this.)

Sourced preference. The Egyptian EML 2025 lists doxycycline as second choice for mild-to-moderate community-acquired pneumonia, and clarithromycin is demoted for local pneumococcal macrolide resistance above 40%.

Egyptian National Drug Formulary - Antimicrobial 2023 (doxycycline monograph)

The Egyptian EML 2025 lists doxycycline as second choice for mild-to-moderate community acquired pneumonia, and it sits in the Access group where clarithromycin and levofloxacin sit in Watch. It covers Mycoplasma, so it is the atypical cover to reach for where a macrolide is unsuitable.

1 g BID or 875/125 mg BID x 7 days

80-90 mg/kg/day [child max 4000 mg]

(Of the amoxicillin component, divided twice daily. Use a 14:1 ES-600 formulation to keep clavulanate under 10 mg/kg/day at this amoxicillin dose. The formulary caps this regimen at a maximum daily dose of 4,000 mg of the amoxicillin component.)

Egyptian National Drug Formulary - Antimicrobial 2023

Beta-lactam combined with a beta-lactamase inhibitor, used as first-line empirical outpatient therapy for community-acquired pneumonia; the inhibitor restores activity against beta-lactamase-producing organisms that amoxicillin alone would miss.

Community-Acquired Pneumonia - disease-level clinical article (community-acquired-pneumonia-clinical.txt)

Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.

1 g three or four times daily, maximum 4 g in 24 hours - while febrile or the chest hurts, usually 3-5 days

15 mg/kg/dose [child max 500 mg]

(15 mg/kg per dose every 6 hours. WHO restricts oral paracetamol to children 2 months and over with a fever of 39 C or more who are uncomfortable or distressed by it - do not treat a low fever.)

MSF Essential Drugs 2024 - paracetamol (oral)

The WHO pocket book instructs paracetamol for a child with pneumonia and a distressing fever of 39 C or more, and gives 15 mg/kg every 6 hours. The adult dose here is from the MSF drug reference. Paracetamol rather than an NSAID is deliberate - see the cautions.