Outpatient Management of Severe Pneumonia in Developing Countries: A New Option

In developing countries, pneumonia is a leading cause of morbidity and mortality in young children. The World Health Organization (WHO) has developed treatment guidelines for management of three types of lower respiratory tract infections (pneumonia, severe pneumonia, and very severe pneumonia) in developing countries; WHO recommends that children with severe pneumonia (cough or difficulty breathing with lower chest indrawing on physical exam) be referred to a hospital to receive parenteral therapy. Investigators in Pakistan performed a randomized study in 2037 children aged 3 to 50 months to compare inpatient parenteral ampicillin and outpatient high-dose oral amoxicillin for treatment of severe pneumonia. Children with known or suspected …