Symptoms & Treatment of Pneumonia in Children | Kids Clinic Singapore


Dr Dave: 2 May & 13 May - 16 May

Last updated: 19 April

Pneumonia in Children

What Is Pneumonia?

Pneumonia is an infection of the lungs, which can be caused by viruses or by bacteria.

Baby With Pneumonia
Pneumonia is a lung infection which presents with fever, coughing with phlegm, painful or difficulty breathing.

What Are the Symptoms And Signs Of Pneumonia?

  • Fever, sometimes with chills
  • Coughing, usually with a lot of phlegm
  • Occasional painful breathing
  • Fast or difficulty in breathing
  • Some can have associated non-specific and seemingly unrelated symptoms such as abdominal pain, vomiting or diarrhoea
  • Abnormal sounds when the doctor listens to or taps on the chest of the patient
  • Abnormal patch (infiltrate) on chest X-ray

What Is The Expected Course Of Pneumonia?

Only bacterial pneumonia is treatable by antibiotics (e.g. Amoxicillin, Amoxicillin-Clavulanate, Clarithromycin etc., choice dependent on the suspected bacteria and the condition of the patient). Viral pneumonia does not respond to antibiotics, but certain cases caused by the Influenza virus may respond to an anti-viral medication called Tamiflu (Oseltamivir). As it is difficult to distinguish bacterial from viral pneumonia in all cases, antibiotics are usually prescribed. With a course of appropriate antibiotics, the fever should settle within 48 to 72 hours from the start of the antibiotics. The coughing may take longer, up to 2 weeks, to resolve. However, severe cases of pneumonia will need to be admitted to hospital for injection antibiotics (e.g. Ampicillin, Amoxicillin-Clavulanate, Ceftriaxone etc., choice dependent on the suspected bacteria and the condition of the patient).

Discharge Instructions For Home Treatment

  1. Antibiotics: You must complete the course of antibiotics as prescribed by your doctor.
  2. Medicines for fever: Use paracetamol or ibuprofen for fever. This can be repeated every 6 hours. If the fever is 39.5°C or more, you may use the paracetamol every 4 hourly, but only for 1 to 2 days, and subsequently reduced to every 6 hourly. Ibuprofen should be reserved for temperature 38.5°C and above, and it can only be repeated every 6 hours.
  3. Warm fluids for coughing spasms: Coughing spasms are often caused by sticky secretions in the back of the throat. Warm fluids usually relax the airway and loosen the secretions.
  4. Follow-Up Appointments: Your child needs to be reviewed by a doctor. Keep the appointment as given by your attending doctor.

Consult Your Doctor Immediately If:

  • Your child is breathless.
  • The fever is persistent beyond 2 to 3 days from start of antibiotics.
  • Your child is lethargic.
  • There is poor feeding.
  • Your child is not retaining the oral antibiotics due to vomiting. In which case, he/she may need to be admitted to hospital for injection antibiotics, or a change of antibiotics by your doctor.
  • Your child complains of chest pain.

How Do I Reduce The Risk Of Having Pneumonia In My Child?

  • By ensuring that your child has completed his/her vaccinations, especially Pneumococcal (Prevenar 13) and Haemophilus influenzae (part of 5-in-1 and 6-in-1 vaccinations). This would help provide protection against the more common bacterial causes of pneumonia. However, please note that there are several other bacteria (e.g. Mycoplasma pneumoniae, Staphylococcus aureus, Moraxella Catarrhalis), which can cause pneumonia and there are currently no vaccinations effective against these bacteria.
  • By having annual Influenza vaccinations for your child and your family, you can reduce the risk of Influenza infection, which can cause pneumonia and other chest infections such as bronchitis/bronchiolitis as well. However, please also note that there are many other viruses (e.g. Respiratory Syncytial Virus, RSV), which can cause chest infections and there are currently no vaccinations effective against these viruses.
  • By washing hands and staying away from people who are sick
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