A trial reported on in The Lancet found that switching from intravenous (IV) to oral antibiotics after clinical improvement was safe and effective in young children with severe pneumonia. CIDRAP has the news.

Severe pneumonia isn’t as dangerous as it once was in children, but it is still a leading cause of childhood mortality and hospitalization worldwide. Researchers wished to investigate whether a step-down from IV to oral antibiotics after clinical improvement is as effective as IV-only treatment for severe cases.

The study assigned 1,101 children aged 2 months to 6 years with severe community-acquired pneumonia (CAP) in Africa to switch from IV to oral antibiotics or receive the full five-day IV treatment. Children in the two oral step-down groups received a median of two days of IV antibiotics. Results indicated that both oral step-down strategies – to amoxicillin or amoxicillin-clavulanate – were non-inferior to the IV-only strategy.

Children in the step-down groups spent a day less in the hospital than those in the IV-only group. The first study author said that “this simple change could help children get back to their families sooner, reduce pressure on busy hospitals, lower healthcare costs, and avoid sometimes catastrophic financial impacts on families from lost caregiver earnings.”