For a 3-year-old with cough and mild fever, what is the most appropriate treatment when pneumonia is suspected?

When pneumonia is suspected in a 3-year-old child, particularly in the absence of specific risk factors that would suggest atypical pathogens, amoxicillin is considered the most appropriate treatment option. Amoxicillin is a first-line antibiotic for the treatment of community-acquired pneumonia in young children, particularly those who are otherwise healthy and have not been recently treated with antibiotics.

This choice is based on its effectiveness against the most common bacteria that cause pneumonia in this age group, primarily Streptococcus pneumoniae and Haemophilus influenzae. The safety profile of amoxicillin is well established, making it a preferred option for treatment in pediatric patients.

In contrast, the other antibiotics listed—ciprofloxacin, azithromycin, and levofloxacin—are not typically the first-line choices for treating pneumonia in young children. Ciprofloxacin and levofloxacin belong to the fluoroquinolone class and are generally reserved for more complicated infections or specific indications due to concerns about adverse effects in young children and the risk of developing resistance. Azithromycin might be used in cases where there is a concern for atypical pneumonia, such as Mycoplasma pneumoniae, but it is not the first choice for typical bacterial pneumonia in preschool children.