Parapneumonic effusion/empyema

Duration of therapy

14-28 days total, if adequate drainage and no additional complications


Switch to oral antibiotics: drainage completed, clinical improvement, no oxygen (usually before discharge)
If no pathogen is isolated, amoxicillin is the oral antibiotic of choice if Hib immunizations up to date

Suggested regimen:

The presence of an effusion/empyema does not direct antimicrobial choice. Antibiotics should be guided by severity of presentation.

If previously healthy and up to date on Hib immunizations:

If NOT up to date on Hib immunizations or if admitted to PICU for severe illness (not just for chest tube insertion):