TABLE 1.

Studies defining treatment failure in severe or very severe pneumonia.

Reference	Study population	N	Clinical Definition of Treatment Failure	Failure
Shann et al. 1985(29)	Ages not stated; Papua New Guinea; Inpatients; Severe pneumonia	748	At any point: Change of antibiotic treatment; Death	15.9%
Strauss et al. 1998(30)	2–59 months; Pakistan; Outpatient and inpatient; Non-severe and severe pneumonia	595	At 48 hours, any of: Resting SaO2 ≤ 87%; tachypnoea; any danger sign; No improvement or deterioration in the opinion of a senior clinician	20.5%
Duke et al. 2002(31)	1-59 months; Papua New Guinea; Inpatient; Very severe pneumonia	1116	At 5 days, any 4 of: Fever, Tachypnoea/apnoeas, chest wall indrawing, crepitations, bronchial breathing, low oxygen sats; Death ; Readmission within 1 month	18.6%
Addo-Yobo et al. 2004(14)	3–59 month; International; Inpatient; Severe pneumonia	1702	At 48 hours, any 1 of: Danger signs, low SaO2, persistent indrawing, serious adverse drug reaction, new antibiotic, new comorbidity, abscondment, death	19%
McNally et al. 2007(5)	1-59 months; South Africa; Inpatient; Severe and very severe pneumonia	358	At 48 hours, persistence or worsening of any 1 of: heart rate, respiratory rate, temperature, inability to drink, increased oxygen requirements; New danger signs; Absconded; Change of antibiotic for new disease or blood culture result; Death	35%
Asghar et al. 2008 (12) (SPEAR study)	2-59 months; International; Inpatient; Very severe pneumonia	958	At day 5, persistent or new: Inability to drink, tachypnoea, reduced conscious level, meningitis, empyema, renal failure, septic shock; Serious adverse drug reaction; Change of antibiotic treatment; Abscondment; Death	13.5%
Hazir et al 2008(15)	3-59 months; Inpatient versus outpatient; Severe pneumonia	2037	At day 3: Clinical deterioration; Persistence of fever with lower chest indrawing; Hospitalisation of outpatient; Development of comorbid condition requiring antibiotic; Abscondment; Death	8%
Addo Yobo et al. 2011(32)	2-59 months, multi-national; Severe pneumonia	823	At 72 hours, persistence of fever and lower chest indrawing. Or, at day 6, clinical deterioration; Inability to take oral medication because of persisting vomiting; serious adverse event related to amoxicillin; developing a co-morbid condition; either fever or lower chest indrawing; new chest indrawing or fast breathing	9.2%