Moving Children with Severe Pneumonia from IV to Oral Antibiotics

For children with pneumonia, studies have demonstrated the benefits of oral over intravenous (IV) antibiotics and of shorter treatment courses, but mainly for mild-to-moderate disease. To identify the optimal antibiotic duration, route, and type for severe pediatric community-acquired pneumonia, researchers conducted an open-label, multicenter, randomized trial in five sub-Saharan African countries. Following clinical improvement with at least 24 hours (median, 2 days) of IV antibiotics, about 1000 children 2 months to 6 years of age either continued IV therapy for a total of 5 days or switched to oral high-dose amoxicillin, randomized with or without clavulanate. Those who switched were further randomized to receive 4, 5, 6, 7, or 8…