Community-acquired pneumonia (CAP), otitis media (OM) and acute bacterial rhinosinusitis (ABRS) are common childhood illnesses. Although OM is more typically a childhood infection, CAP and ABRS are also common in adults. However, important differences exist in pathogenesis and treatment. Causative pathogens differ between children and adults. Streptococcus pneumoniae remains the predominant pathogen, and Haemophilus influenzae causes CAP less frequently in children than in adults, although this continues to evolve with the introduction of pneumococcal vaccines and may yield future changes to recommended empiric therapy. Additionally, Mycoplasma pneumoniae is the primary atypical pathogen in pediatric CAP but usually only in certain age groups with specific presenting features, and therefore it does not warrant universal empiric coverage.

Although beta-lactams are mainstays of IV treatment in the hospital setting for both children and adults, adult patients often complete treatment with oral fluoroquinolones or doxycycline, which have limited utility in children and are not preferred as first-line agents. Oral beta-lactams are therefore used frequently for outpatient management of pediatric respiratory infections, and proper selection of agent and dose are important and common sources of error.