Antibiotics for Pediatric Community-Acquired Pneumonia: Less Might Be More

In 2011, the Pediatric Infectious Disease Society released guidelines recommending amoxicillin for initial treatment of community-acquired pneumonia (CAP; NEJM JW Pediatr Adolesc Med Nov 2011 and Clin Infect Dis 2011 Oct; 53:617). Traditional treatment duration is 10 days, but studies in adults have demonstrated equivalent effectiveness of shorter courses. In the SAFER (Short Course Antimicrobial Therapy for Pediatric Respiratory Infections) study, investigators in Canada randomized 281 outpatients (age range, 6 months–10 years) with CAP to receive 5 days of amoxicillin followed by either 5 days of placebo or 5 additional days of amoxicillin. All participants with persistent fever at 96 hours received open-label amoxicillin for the 5 additi…