Table 2.

Definitions of treatment failure

Pneumonia severity classification	Treatment failure: Criterion 1 (a priori definition) – any of the numbered criteria listed Criterion 2 (post hoc definition) – any of the numbered criteria listed except (iv) for SP and (v) for VSP
SP	(i) Development of signs of VSP or death at any time (ii) Absence of improvement of all of the following: (a) indrawing (persistence), (b) measured temperature reduction of ≥0.5 °C, (c) respiratory rate (reduction of ≥5 bpm) (iii) Identification of pathogen with in vitro resistance to the antibiotics at any time point (iv) Senior clinician's decision to change antibiotic treatment or initiate TB treatment following initial treatment allocation shown in Figure 2
VSP	(i) Observed deteriorating level of consciousness (reduction in AVPU), death or development of respiratory failure resulting in the need for ICU transfer at any time point (ii) Chest X-ray findings indicative of lung abscess, bullae formation or pulmonary TB at any time point (iii) Absence of improvement of all of the following: (a) indrawing (persistence), (b) measured temperature reduction of ≥0.5 °C, (c) respiratory rate (reduction of ≥5 bpm), (d) ability to drink, (e) requirement of supplementary oxygen (iv) Identification of a pathogen on blood culture or from pleural fluid with in vitro resistance to the antibiotics at any time point (v) Senior clinician's decision to start the child on second line treatment or TB treatment following initial treatment allocation shown in Figure 2

SP, severe pneumonia; VSP, very severe pneumonia.