Community-acquired pneumonia (CAP) is a significant cause of respiratory morbidity and mortality in children, especially in developing countries. Worldwide, CAP is the leading cause of death in children younger than five years.

Clinical assessment requires careful evaluation of clinical features, severity, and evidence of complications. The diagnosis can be based on the history and physical examination results in children with fever plus respiratory signs and symptoms. Chest radiography and rapid viral testing may be helpful when the diagnosis is unclear.

The most likely etiology depends on the age of the child. Viral and Streptococcus pneumoniae infections are most common in preschool-aged children, whereas Mycoplasma pneumoniae is common in older children.

TAKE HOME MESSAGE:

WHO recommendations for the management of Community Acquired Pneumonia (CAP) have been revised since 2014, recommended empirical first line treatment is oral amoxicillin. Intravenous antibiotics are indicated in children who cannot tolerate oral medicines or have septicaemia or complications.

A Double-Blind, Randomized, Controlled Trial study was planned to compare cure rate of oral amoxicillin plus clavulanic acid vs oral amoxicillin in children with CAP.

Children aged 6- 36 months, presenting with the clinical features consistent with the diagnosis of CAP were enrolled. Patients were given oral amoxicillin or amoxycillin plus clavulanic acid for 5 d and followed at 48h, 5^th d and 2 months. The cure rate, adverse reactions and recurrence were assessed and analyzed for these two drugs.

The chances of cure rate increased by 15.3% for children receiving oral amoxicillin plus clavulanic acid. Only mild side effects like diarrhea (22.1%), nausea (9.6%), vomiting (5.7%), and maculo-papular rash (2.9%) were observed in both the groups.

The cure rate of CAP in amoxicillin plus clavulanic acid group was significantly higher as compared to amoxicillin group (93.88% vs 79.17%).

All the cured children were followed up to 2 months and none had recurrence of symptoms.