Table 2.

Questions, recommendations and strength, quality of evidence, and Consensus panel

Question	Recommendation	Quality of evidence	Strength of the recommendation	Consensus panel
1. What is the first-line antibiotic for treating mild-to-moderate CAP in a child under five years old with a complete immunization schedule (at least two doses of hexavalent and pneumococcal vaccines)?	In children under five with a complete immunization schedule and mild-moderate CAP, amoxicillin prescription is recommended.	Low/very low	Strong recommendation in favor of the intervention	100%
2. What is the first-line antibiotic for treating mild-moderate CAP in a child over five years old with a complete immunization schedule (at least two doses of hexavalent and pneumococcal vaccines)?	In children over five years of age with a complete immunization schedule and mild-moderate CAP, treatment with amoxicillin is recommended.	Low/very low	Strong recommendation in favor of the intervention	100%
	In children who remain well-appearing and do not require hospitalization, macrolide therapy is recommended if there is no clinical improvement after 48 h of amoxicillin treatment.	Low/very low	Strong recommendation in favor of the intervention	100%
3. What is the first line antibiotic for treating mild-moderate CAP in a child without a complete immunization schedule (< 2 doses of hexavalent and pneumococcal vaccines)?	In children who are either unimmunized or have incomplete immunization against S. pneumoniae but are immunized for H. influenzae (having received more than two doses of hexavalent vaccine but less than two doses of pneumococcal vaccine) and present with mild-moderate CAP, monotherapy with amoxicillin is recommended as the first-line therapy.	Low	Strong recommendation in favor of the intervention	100%
	For children who are either unimmunized or have incomplete immunization coverage for both H. influenzae and S. pneumoniae (having received less than two doses of hexavalent and pneumococcal vaccines), first-line therapy with amoxicillin-clavulanate or second or third-generation cephalosporins is recommended.	Low	Weak recommendation in favor of the intervention	100%
4. What is the first-line antibiotic in the treatment of mild-moderate bacterial CAP in patients allergic to penicillin?	In patients with CAP and a suspected allergy to amoxicillin, who have not undergone allergological workup, the selection of alternative antibiotics (such as third-generation cephalosporins or macrolides) should be guided by meticulous risk stratification.	Very low	Strong recommendation in favor of the intervention	100%
	In patients with CAP suspected of having an allergy to amoxicillin and deemed to be at low risk of allergic reaction, a second or third-generation cephalosporin (such as cefuroxime or cefpodoxime proxetil) is recommended as an alternative therapy. The utilization of macrolides (like clarithromycin) or clindamycin should be reserved for patients at high risk of allergic reaction, with consideration given to levofloxacin for older children	Very low	Weak recommendation in favor of the intervention	100%
5. What should be the optimal dosage of amoxicillin in treating mild to moderate bacterial CAP?	To treat mild-moderate CAP, we recommend administering amoxicillin at a dosage of 80–90 mg/kg/day divided into three separate doses (with a maximum of 1 g three times a day). However, to enhance compliance with antibiotic therapy, particularly in cases of mild pneumonia with close clinical follow-up, the number of daily administrations can be reduced to two instead of three.	Moderate	Weak recommendation in favor of the intervention	100%
Question 6. What should be the optimal length of therapy with amoxicillin for treating mild -moderate bacterial CAP?	For the management of mild-moderate CAP, a 5-day course of antibiotic therapy with amoxicillin is recommended. Close clinical monitoring and reassessment are advised approximately 72 h after initiating antibiotic therapy to evaluate symptom resolution. If necessary, treatment may be extended for up to 7 days.	Moderate	Strong recommendation in favor of the intervention	100%
7. What is the most appropriate antibiotic therapy in a child with CAP experiencing clinical deterioration after 48 h of first-line therapy with amoxicillin?	In children experiencing clinical deterioration after 48 h of first-line therapy, hospitalization and treatment with broad-spectrum antibiotics are recommended.	Very low	Weak recommendation in favor of the intervention	100%