If a child does not improve or the child's condition deteriorates, further evaluation is necessary. Chest radiograph may be repeated in this control evaluation. Teaching the parents to measure the respiratory rate during sleep or rest enables objective information. If initial treatment fails, depending on the reevaluation, possible hospitalization and additional diagnostic studies should be considered, in addition to alterations in therapy. Other etiologic bacteria are Mycoplasma pneumoniae, S. pyogenes, S. aureus, Chlamydia pneumoniae, Moraxella catarrhalis and Legionella pneumophilia.
Most physicians initiate therapy with erythromycin or new macrolides.
Some physicians prefer a therapeutic trial over testing for cold agglutinins when Mycoplasma pneumoniae is strongly suspected. In hospitalized patients, besides cold agglutinins, Mycoplasma cultures and serologic studies should be considered. Institute the appropriate treatment. Fever is not an efficient criterion. Identification of Pneumonia Cases Fast breathing is a better predictor of pneumonia than auscultatory findings.