Table 3

Oral versus parenteral antibiotics for severe community-acquired pneumonia (CAP) in children

AuthorMethodsStudy populationInterventionsOutcomes
Campbell, 198856Multicentre controlled study134 children of mean age 22 months and WHO-defined severe CAP in GambiaRandomly assigned to oral co-trimoxazole for 5 days or procaine penicillin + benzylpenicillin one dose followed by oral ampicillin for 5 days

  • Improved after 7 days: 66.6% in the oral only group and 60.3% in the combined group

  • Treatment failure after 14 days: 7.6% in the oral only group and 7.3% in the combined group

Addo-Yobo, 200457Multicentre randomised open-label equivalency trial1702 children aged 3–59 months with WHO-defined severe CAP in developing countries (Africa, Asia, and South America)Randomly assigned to oral amoxicillin or IV penicillin G, both groups for 48 h followed by oral amoxicillin for another 5 days

  • Treatment failure after 48 h: 18.6% in the amoxicillin group and 18.8% in the penicillin group

  • Treatment failure between 48 h and 5 days: 1.8% in the amoxicillin group and 2.2% in the penicillin group

  • Treatment failure between 5 and 14 days: 2.2% in the amoxicillin group and 1.5% in the penicillin group

Atkinson, 200758Multicentre randomised controlled non-blinded equivalency trial246 children aged ≥6 months with radiologically-confirmed CAP in EnglandRandomly assigned to oral amoxicillin for 7 days or IV benzylpenicillin, changed to oral amoxicillin after a median of six IV doses for a total course of antibiotics of 7 daysTreatment failure: 2.4% in the oral group and 5.8% in the IV group
Hazir, 200859Multicentre randomised open-label equivalency trial2037 children aged 3–59 months with WHO-defined severe CAP in PakistanRandomly assigned to ambulatory group (oral amoxicillin for 5 days) or hospitalised group (IV ampicillin for 48 h followed by 3 days of oral amoxicillin)

  • Cured: 90% in the ambulatory group and 88% in the hospitalised group

  • Died: 0.09% in the ambulatory group and (0.04%) in the hospitalised group

  • IV, intravenous.