E) Ampicillin and oseltamivir

G) Ceftriaxone and oseltamivir

• The predominant pathogen for pediatric community-acquired pneumonia in previously healthy patients is Strep pneumoniae
• IDSA guidelines recommend amoxicillin for outpatient treatment, and either ampicillin or ceftriaxone for inpatient treatment
• Given that it is flu season, influenza is a possible cause of the child’s symptoms
– CDC recommends treatment with oseltamivir for suspected influenza in high-risk children (< 5 years old is a risk factor) if given within 48 hours of symptoms
– However, CDC states that hospitalized patients may benefit from antiviral treatment even if begun more than 48 hours after onset of illness. Since this patient is being hospitalized, oseltamivir is indicated
• References
– Bradley JS et al. ClinInfect Dis 2011;53(7):e25-76
– CDC influenza information