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Community-acquired pneumonia is common and remains associated with substantial morbidity and mortality, especially in lower and middle-income countries. While standardising care is one important component in reducing mortality from severe pneumonia initially requiring hospitalisation, the antibiotics used are also clearly key. Optimising antibiotic treatment includes defining the right drug, right duration, right delivery and right dose. At present, strong data to support clinical decision-making for each of these factors in very severe/severe childhood pneumonia requiring inpatient care in lower and middle-income countries are lacking.