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Child has fever, cough. On amoxicillin. Chest x-ray done. Found pneumonia. What to do?

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Internal Medicine Specialist
Practicing since : 1996
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son 11 has been sick for one week persistent fever and coughing. He was put on amoxicillin 2.5 days ago. he got a chest xray yesterday which confirmed pneumonia. His fever is not coming down after 2.5 days of amoxicillin. The fever runs from 99.5 -102. What should I do?
Posted Thu, 2 May 2013 in Lung and Chest disorders
Answered by Dr. Prasad Akole 23 minutes later
Dear friend, welcome and thanks for entrusting your query here at Healthcaremagic!
I am Dr. Prasad Akole (Critical Care Expert- and am glad to address to your query here.

I am really concerned about his diagnosis.
Pneumonia could be due to viral or bacterial causes.
2.5 days course of amoxicillin is very inadequate to bring any relief. Give it 7-10 days to act.
Is he bringing out sputum? What is the quantity, colour, is there any blood in it?
Does he have chest pain?
Is he breathless?
Has sputum been cultured?
It would greatly help if you could upload any reports here using the uploading service available on this site just below the text box. You can email the reports / scans to
YYYY@YYYY      with subject- (Attn: Dr. Prasad Akole)
I would recommend to do a complete blood work including hemogram, urine routine, any rapid pneumonia diagnostic kit test available there, EKG.
Sputum properly collected should be sent for gram and Zn staining and be cultured.
A macrolide like azithromycin or clarithromycin should be added to cover any atypical organisms causing pneumonia.
Many viral pneumonias get secondary bacterial infection after a week or so.
Influenza and respiratory infection viruses rapid diagnostic tests are available.

Please consult your doctor for all these and take the advised treatment. Ask if an anti-viral is needed.

Oxygen saturation should be checked. If too sick, should be admitted.
Respiratory etiquette is to be followed.

Antibiotics are the modified according to sensitivity report.

It takes about 7-10 days to get relief.

Continue supportive care like paracetamol for fever, mucolytics, steam inhalations etc.

keep a watch on complications like breathlessness, blood in sputum, dehydration, drowsiness, unremitting fever etc.

I hope to have answered your query satisfactorily. I would be glad to answer any further queries. Take care and please keep me informed of your progress at
Good Luck!

It helps us to improve continuously if you could please write a rating review before you ‘accept’ and ‘close’ the query.
Thank you!!
Above answer was peer-reviewed by
Follow-up: Child has fever, cough. On amoxicillin. Chest x-ray done. Found pneumonia. What to do? 4 hours later
Thank you. We gave him Motrin last night at 8:30 and his temp came down. By 3:30 AM. his temp was up to 103.9F. We took him to emergency room at 5 AM. Yesterday he had an Xray (positive pneumonia) although I am waiting on a radiologist to confirm - it was his pediatrician who made the diagnosis. He also had blood work done but no sputum (culture). No results yet.

He does not really have chest pain and he is not bringing up sputum. His cough fairly constatnt, dry and unproductive. I will upload lab results when I get them. He did not do a pneumonia diagnostic (I have never heard of this).

When he was in hospital last night his pulse was @120. The pulsox (oxygen saturation) read 88-95 (it varied). He is also taking through the day a bronchodilator (aerosol).
Answered by Dr. Prasad Akole 6 hours later
Thanks for the info.
So, it is a pneumonia with a non productive cough and mild hypoxia (oxygen deficit).

Motrin will typically act for 6-8 hours.

Try to get some sputum, if he can, after steam and nebulization for gram stain and culture.
We do rapid atypical pneumonia antibody panel in some cases. Ask if it is possible there. All places do not do it.

I would advise more once I get the reports/ Xray image.
Follow the advice in my earlier reply.

Wish him speedy recovery.
Above answer was peer-reviewed by
Follow-up: Child has fever, cough. On amoxicillin. Chest x-ray done. Found pneumonia. What to do? 13 minutes later
His doc put him on an additional antibiotic today, clarithromycin (in addition to the amoxicillin). I assume you would approve, in lieu of cultures and pneumonia testing. I still don't have reports yet. Is this my last reply? Should I continue to alternate Tylenol and Motrin 24 hours a day to avoid the serious fever spikes?
Answered by Dr. Prasad Akole 15 minutes later
Good that clarithro is added, as he is not producing sputum sample.
Yes, you can alternate Motrin and Tylenol for fever, pain.

You may top-up and continue asking or return at
when you have reports or more queries.
Above answer was peer-reviewed by
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