Oral step-down, optimal drug, and total duration of antibiotic treatment in African children hospitalised with severe community-acquired pneumonia (PediCAP): a factorial randomised controlled trial

The study aimed to determine the safety and effectiveness of stepping down from intravenous antibiotics to oral amoxicillin or amoxicillin-clavulanate in children hospitalized with severe community-acquired pneumonia in sub-Saharan Africa, and to identify the shortest effective treatment duration. Results indicated that a step-down strategy to oral antibiotics after initial intravenous treatment, with a total duration of 4-5 days, was non-inferior to the WHO-recommended 5-day intravenous treatment, suggesting a potential for shorter antibiotic courses without compromising patient safety.